tag:theconversation.com,2011:/id/topics/intimate-partner-violence-15047/articlesIntimate partner violence – The Conversation2018-07-01T20:11:01Ztag:theconversation.com,2011:article/969822018-07-01T20:11:01Z2018-07-01T20:11:01ZHow forced pregnancies and abortions deny women control over their own bodies<figure><img src="https://images.theconversation.com/files/223132/original/file-20180614-32307-1ypkpxb.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Contraception is sometimes controlled in abusive relationships. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>For most women in Australia, the decision about whether or not to have a baby is a profoundly personal one. But for some, control over this decision is taken away from them, usually by an abusive male partner. This can happen via the use of verbal pressure, threats, blackmail, physical violence or rape. </p>
<p>In 2010, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282154/">researchers in the US</a> came up with the term “reproductive coercion” to describe these behaviours. Since then, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018410/">some work</a> has been done, primarily in US family planning clinics, to help understand reproductive coercion. </p>
<p>Despite this, it mostly remains a hidden issue. We don’t know how common it is, and it’s very likely (as with most forms of violence against women) it’s grossly under-reported. The US <a href="https://www.cdc.gov/violenceprevention/nisvs/index.html">National Intimate Partner and Sexual Violence Survey</a> suggested around 8% of respondents had experienced reproductive coercion in their lifetimes, although the survey only asked about a limited range of behaviours. </p>
<p>In Australia, we don’t have any reliable prevalence data. But Queensland organisation <a href="https://www.childrenbychoice.org.au/factsandfigures/reproductivecoercion">Children By Choice</a> reported they’re seeing it in around one in seven women presenting for abortions. </p>
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Read more:
<a href="http://theconversation.com/factcheck-is-domestic-violence-the-leading-preventable-cause-of-death-and-illness-for-women-aged-18-to-44-94102">FactCheck: is domestic violence the leading preventable cause of death and illness for women aged 18 to 44?</a>
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<h2>What is reproductive coercion?</h2>
<p>Reproductive coercion typically takes three different forms: </p>
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<li><p>pregnancy coercion, where a woman is forced or manipulated into becoming pregnant</p></li>
<li><p>birth-control sabotage, where a woman is prevented from using contraception, or her contraception is tampered with</p></li>
<li><p>control of pregnancy outcomes, where a woman is forced to continue or terminate a pregnancy. </p></li>
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<p>Reproductive coercion overlaps with intimate partner violence and sexual violence.</p>
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<span class="caption">Intimate partner violence, sexual violence and reproductive coercion are all related.</span>
<span class="attribution"><span class="source">Laura Tarzia</span></span>
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<p>Studies consistently show a relationship between intimate partner violence, which affects around <a href="https://www.anrows.org.au/publications/horizons-0/PSS">one in four</a> Australian women, and <a href="https://www.arhp.org/publications-and-resources/contraception-journal/june-2010">unintended pregnancy</a>. </p>
<p>But whether this is through the male partner intentionally trying to get his partner pregnant, or simply a side effect of the woman having little control over the timing and frequency of sex, is unclear. </p>
<p>Many women in violent relationships are unable to negotiate the use of contraception, particularly if relying on methods such as condoms that depend on the male partner. Others are too fearful to refuse sex, even if they know they’re risking a pregnancy. Some women are raped by their partners. </p>
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Read more:
<a href="http://theconversation.com/study-confirms-intimate-partner-violence-leading-health-risk-factor-for-women-67772">Study confirms intimate partner violence leading health risk factor for women</a>
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<p>Both women in violent relationships, and women whose partners force or coerce them into becoming pregnant have little control over their own bodies. It’s important to distinguish between deliberate behaviours intended to get a woman pregnant, and sexually coercive behaviours in relationships that may result in an unintended pregnancy. </p>
<p>As so little research has been done in this area, we don’t really understand how the experience of having an unintended pregnancy after being sexually assaulted differs from being deliberately forced to become or stay pregnant. </p>
<p>We don’t know whether experiencing a miscarriage as a result of physical violence is similar to being forced to have an abortion. More research is urgently needed in this area so we can understand women’s experiences and how best to support them.</p>
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<span class="caption">Not all health care workers know what signs to look out for.</span>
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<h2>Health services and reproductive coercion</h2>
<p><a href="https://link.springer.com/article/10.1007/s10995-014-1653-2">Research</a> tells us women experiencing reproductive coercion are more likely to access health care services. In particular, abortion clinics, general practitioners, and antenatal services.</p>
<p>But little is known about how practitioners working in these settings identify it in their patients, or how they respond if women disclose. In Australia, we don’t yet have best practice guidelines about how health practitioners should identify and respond to reproductive coercion. </p>
<p>The <a href="https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion">American College of Obstetricians and Gynaecologists</a> recommends practitioners ask every female patient about reproductive coercion. But we currently lack evidence to support this approach. </p>
<p>This does not mean it’s wrong, rather there isn’t enough research to support “universal screening” as opposed to “case finding”, where practitioners enquire only after warning signs are detected or coercion is suspected. </p>
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Read more:
<a href="http://theconversation.com/why-are-rates-of-domestic-violence-in-australia-still-so-high-87187">Why are rates of domestic violence in Australia still so high?</a>
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<h2>How can we prevent it?</h2>
<p>It’s clear more community awareness is needed about reproductive coercion. Health practitioners can help women experiencing reproductive coercion by prescribing female-controlled or hidden methods of contraception (such as an implantable intrauterine device with a shorter string that is undetectable by a partner). </p>
<p>They can also provide women with information about their reproductive rights, alert them to the abuse happening in their relationship, and provide referrals if appropriate. Safe, low-cost and reliable access to abortion and other reproductive health services are also critical.</p>
<p>But none of these solutions is a silver bullet. Like many forms of violence against women, the real road to prevention is broader social change towards gender equality. Specifically, a shift away from a culture of male entitlement to women’s bodies and towards real recognition of women’s reproductive rights.</p><img src="https://counter.theconversation.com/content/96982/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Tarzia receives funding from the Australian Research Council through a Discovery Early Career Researcher Award. </span></em></p><p class="fine-print"><em><span>Molly Wellington does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Associated with intimate partner violence, there are many ways in which reproductive choice is taken away from women.Laura Tarzia, ARC DECRA Senior Research Fellow, Department of General Practice, University of MelbourneMolly Wellington, University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/950482018-04-26T08:00:22Z2018-04-26T08:00:22ZPregnant women are at increased risk of domestic violence in all cultural groups<figure><img src="https://images.theconversation.com/files/216426/original/file-20180426-175074-q6jr9a.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Women having a subsequent baby are more likely to disclose domestic violence than first time mothers.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1059281756?src=CyQd4Z4-wdqBDSLlvqiEtA-1-99&amp;size=medium_jpg">Vyshnova/Shutterstock</a></span></figcaption></figure><p>Domestic violence occurs across all age groups and life stages. Rather than reducing during pregnancy, expecting a child is a <a href="https://aifs.gov.au/cfca/publications/domestic-and-family-violence-pregnancy-and-early-parenthood">key risk factor for domestic violence beginning or escalating</a>. </p>
<p>Our research, <a href="http://bmjopen.bmj.com/content/8/4/e019566">published today in the journal BMJ Open</a>, found that 4.3% of pregnant women due to give birth in Western Sydney disclosed domestic violence when asked about it by a midwife at her first hospital visit. The study examined more than 33,000 ethnically diverse women who gave birth between 2006 and 2016, and found that these disclosures spanned all cultural groups. </p>
<p>Domestic violence in pregnancy not only causes distress and trauma for the mother and baby, it increases the risk of the baby having a low birth weight (very small baby) or being born prematurely (before 37 weeks), which is linked to jaundice, anaemia and respiratory distress in infancy, and diabetes and heart disease later in life. </p>
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Read more:
<a href="http://theconversation.com/midwives-can-help-detect-domestic-violence-heres-how-37918">Midwives can help detect domestic violence – here's how</a>
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<h2>Abuse and trauma</h2>
<p>Depending on the state or territory, women may receive a <a href="http://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2010_004.pdf">“psychosocial” assessment</a> from midwives when they first book into a public hospital during pregnancy. This screens for depression, anxiety, childhood abuse, domestic violence, support and stress.</p>
<p>Using these assessments, we found that 4.3% of women disclosed domestic violence overall, but rates were higher among women having a subsequent baby, compared with first-time mothers. </p>
<p>We’re unsure if this is because violence has escalated for these women with subsequent pregnancies; if they trust health providers more to disclose the violence; or if they seek help because they’re becoming more aware of the impact of domestic violence on their children. </p>
<p>We found a strong link between the disclosure of childhood abuse and the disclosure of domestic violence. Nearly 24% of women disclosing domestic violence had also disclosed childhood abuse. </p>
<p>This doesn’t mean that one causes the other, but women who experience childhood abuse are more vulnerable to re-victimisation (being abused again). They may feel like they’re not worthy and gravitate towards men who abuse them.</p>
<p>Women who disclosed domestic violence in our study were more likely to have a history of anxiety or depression (34%) and have thoughts of harming themselves. </p>
<p>This is concerning, as <a href="https://theconversation.com/we-need-to-protect-new-mothers-from-trauma-and-suicide-17254">maternal suicide</a> during pregnancy or following the birth appears to be rising and has now become one of the <a href="https://theconversation.com/factcheck-is-suicide-one-of-the-leading-causes-of-maternal-death-in-australia-65336">main causes</a> of maternal death in Australia.</p>
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Read more:
<a href="http://theconversation.com/we-need-to-protect-new-mothers-from-trauma-and-suicide-17254">We need to protect new mothers from trauma and suicide</a>
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<p>We also found rising rates of pregnant women disclosing domestic violence and being admitted to hospital for bleeding and signs that labour may be starting early (before 37 weeks). When this happens, women are admitted to hospital to try to stop the labour, or to find the source of the bleeding. Sometimes stress can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179976/">contribute</a> to preterm birth and bleeding in pregnancy.</p>
<h2>Ethnic backgrounds</h2>
<p>We found that domestic violence occurred across all cultural groups, but reported rates were highest among women from New Zealand and Sudan. </p>
<p>Previous research has shown high rates of domestic violence among Maori women in some parts of <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.838.4995&amp;rep=rep1&amp;type=pdf">New Zealand</a>. </p>
<p>There is also evidence of high rates of domestic violence among <a href="https://www.reuters.com/article/us-southsudan-women-violence/south-sudan-war-seeps-into-homes-spurring-domestic-violence-idUSKBN1DT196">Sudanese</a> women prior to migration.</p>
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Read more:
<a href="http://theconversation.com/family-violence-victims-need-support-not-mandatory-reporting-44133">Family violence victims need support, not mandatory reporting</a>
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<p>We found that women born in India and China reported very low rates of domestic violence. This may reflect a cultural tendency not to discuss what is considered private family business with outsiders.</p>
<p>It’s important that health professionals know how to ask about domestic violence in a culturally appropriate way so women feel comfortable disclosing abuse and can access appropriate support. </p>
<h2>What needs to be done?</h2>
<p>Midwives need to consider cultural norms and acceptability when asking migrant women questions about domestic violence, and this must always be done in a way that keeps the woman safe. Partners should not be present when the questions are asked – and this may be done at another time in the pregnancy if necessary.</p>
<p>Where English is not the first language, interpreters should be used. But this can also present challenges if the interpreter comes from the same community and is known to the woman.</p>
<p>When women have <a href="https://theconversation.com/call-the-midwife-playing-catch-up-with-australias-maternity-care-22544">continuity of midwifery care</a> and get to know a midwife well throughout the pregnancy, it is easier for midwives to gain women’s trust and to notice when things change. This style of care should be rolled out more widely in Australian public hospitals. </p>
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Read more:
<a href="http://theconversation.com/acting-on-family-violence-how-the-health-system-can-step-up-45592">Acting on family violence: how the health system can step up</a>
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<p><em>The National Sexual Assault, Family &amp; Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.</em></p><img src="https://counter.theconversation.com/content/95048/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hannah Dahlen receives funding from NHMRC and ARC. She is affiliated with the Australian College of Midwives</span></em></p><p class="fine-print"><em><span>Virginia Schmied receives funding from NHMRC ARC</span></em></p>Domestic violence in pregnancy not only causes distress and trauma for the mother, it also poses serious risks for the baby's health and development.Hannah Dahlen, Professor of Midwifery and Higher Degree Director, Western Sydney UniversityVirginia Schmied, Professor, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/927302018-04-16T22:37:56Z2018-04-16T22:37:56ZTraumatic brain injury: The unseen impact of domestic violence<p>The last time Susan’s husband lost his temper, he smashed her head against the kitchen wall so many times she lost count before she managed to flee with just the clothes on her back and some basic identification.</p>
<p>At the local women’s shelter where she ended up, Susan was expected to accomplish a lot during a maximum 30-day stay: Attend counselling, secure employment or social assistance, meet with a lawyer and find permanent housing. </p>
<p>Women like Susan are on the radar in British Columbia right now as April 15-21 marks Prevention of Violence Against Women Week in the province. </p>
<p>The statistics are terrifying: In Canada, <a href="https://www.bwss.org/prevention-of-violence-against-women-week-2018/">one woman is killed every week by her partner</a>; globally, <a href="http://www.who.int/mediacentre/factsheets/fs239/en/">one third of women will suffer violence at the hands of someone they love in their lifetime</a>.</p>
<p>But what if survivors like Susan are also dealing with <a href="http://www.latimes.com/opinion/op-ed/la-oe-1012-garayserratos-tbi-domestic-abuse-20151012-story.html">the effects of a traumatic brain injury</a> along with the fear and trauma of finally having escaped a long-term abusive relationship? </p>
<p>As a neuroscientist and professor at the University of British Columbia with expertise in traumatic brain injury, I know the impacts of this injury can be devastating — ranging from headaches, double vision and nausea to difficulty concentrating, remembering things and completing simple tasks. </p>
<p>It’s also clear the effects tend to be worse when the trauma occurs repeatedly over time, with symptoms lasting for months to years.</p>
<h2>Victims hesitant to seek help</h2>
<p>Much of what we know about traumatic brain injury is the result of a large body of research and media attention over the last 10 to 15 years on athletes and sports-related concussion. </p>
<p>Until recently, the link between traumatic brain injury and intimate partner violence has been largely unexplored. </p>
<p>So, since June of 2017, my research team has been collaborating with <a href="https://kelownawomensshelter.ca/">Kelowna Women’s Shelter</a> in a community-based research project designed to examine the connection between traumatic brain injury and intimate partner violence. </p>
<p>Researching this population can be challenging. Victims are often hesitant to seek help because of the stigma associated with intimate partner violence. </p>
<p>This can lead to a survivor, seemingly paradoxically, <a href="https://theconversation.com/abusive-relationships-why-its-so-hard-for-women-to-just-leave-93449">returning to their abuser repeatedly</a> over the course of months or years, thereby increasing the likelihood of multiple head injuries and chronic symptoms.</p>
<p>Unlike athletes who have suffered a sport-related concussion, survivors of intimate partner violence also quite often experience emotional difficulties such as post-traumatic stress disorder (PTSD), depression and anxiety.</p>
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<p>Despite these challenges, an increasing number of researchers have recently started to examine traumatic brain injury in this vulnerable population. Part of the motivation for doing so is the large number of women thought to be affected.</p>
<p>In particular, <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm?s_cid=ss6308a1_e">the U.S. Centers for Disease Control and Prevention reports</a>, each year, 2.3 per cent of women over the age of 18 experience severe physical violence including “being slammed against something” or “being hit with a fist or something hard.” </p>
<p>Furthermore, up to <a href="https://www.ncbi.nlm.nih.gov/pubmed/26882416">90 per cent of survivors of intimate partner violence report head, neck and face injuries</a> at least once and typically on multiple occasions. </p>
<p>Assuming similar percentages in Canada, this translates into approximately 276,000 women per year who will suffer a traumatic brain injury as a result of intimate partner violence. </p>
<h2>Memory and learning challenges</h2>
<p>Research with this population to date shows <a href="https://www.ncbi.nlm.nih.gov/pubmed/27312572">survivors of intimate partner violence who suffer a traumatic brain injury</a> report symptoms such as headache, difficulty sleeping and cognitive deficits consistent with the head injury.</p>
<p>In terms of brain function, it has been demonstrated the more severe the reported traumatic brain injuries in this population the larger the deficits in memory and learning. These deficits, in turn, are related to <a href="https://www.ncbi.nlm.nih.gov/pubmed/27766587">alterations in how different circuits in the brain communicate with each other</a>. </p>
<p>Our research explores both the emotional and physiological disturbances which occur in women who have survived intimate partner violence, in order to develop a deeper understanding of this issue. </p>
<p>In one part of the study participants complete questionnaires assessing PTSD, depression and anxiety. </p>
<p>In a second part, we carry out cerebrovascular and sensorimotor assessments along with <a href="https://www.ncbi.nlm.nih.gov/pubmed/29026884">blood draws to assess for levels of various markers of brain injury</a>. </p>
<h2>Changing the conversation</h2>
<p>So what does all this science mean for Susan and women like her? In addition to gathering more data on the incidence of traumatic brain injury in this population, our project aims to improve the lives of victims and those who support them.</p>
<p>The fact is, staff at women’s shelters and many other women serving agencies generally don’t have the knowledge, training or tools to screen for brain injury at intake. </p>
<p>This means many clients who have suffered a traumatic brain injury are not getting the support they really need to accomplish their goals and move forward into a life free of abuse.</p>
<p>We hope our research will help change the conversation around traumatic brain injury in this population, as it has for athletes, and shine a spotlight on the unacceptable problem of traumatic brain injury in women at the hands of the ones they love.</p><img src="https://counter.theconversation.com/content/92730/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paul van Donkelaar receives funding from NSERC, SSHRC, and CFI. </span></em></p>Globally, one third of women suffer violence at the hands of someone they love. And for those who survive domestic abuse, traumatic head injury can be the devastating outcome.Paul van Donkelaar, Professor, Faculty of Health and Social Development, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/941022018-04-15T20:12:07Z2018-04-15T20:12:07ZFactCheck: is domestic violence the leading preventable cause of death and illness for women aged 18 to 44?<figure><img src="https://images.theconversation.com/files/212387/original/file-20180328-109169-1q71w2a.jpg?ixlib=rb-1.1.0&amp;rect=17%2C0%2C1920%2C1264&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">It&#39;s not the leading cause but it is the leading contributor.</span> <span class="attribution"><a class="source" href="https://photos.aap.com.au/search/domestic%20violence?q=%7B%22pageSize%22:25,%22pageNumber%22:22,%22Categories%22:%5B%22australian%20news%22%5D%7D">Simone Ziaziaris/AAP</a></span></figcaption></figure><blockquote>
<p>… the leading preventable cause of death and illness for women aged 18 to 44 is violence by a partner or former partner …</p>
<p><strong>– Extract from <a href="https://www.theage.com.au/national/sexual-harassment-laws-in-need-of-review-20180313-p4z47x.html">an editorial</a> in The Age, March 13, 2018</strong></p>
<p>The latest available data shows that the top five causes of death, disability and illness combined for Australian women aged 15-44 years are anxiety and depression, migraine, type 2 diabetes, asthma and schizophrenia.</p>
<p>Violence (let alone the subset of family violence) doesn’t make the list.</p>
<p><strong>– Statement published on the One in Three Campaign <a href="http://www.oneinthree.com.au/misinformation/">website</a>, March 2018</strong></p>
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<p>Violence within intimate and domestic relationships in Australia is a <a href="https://theconversation.com/au/topics/domestic-violence-1115">serious social problem</a> that has devastating consequences. </p>
<p>The statement that intimate partner violence or family violence is the leading preventable cause of death and illness for women aged between 15 (or 18) to 44, has been quoted by <a href="https://www.theage.com.au/national/sexual-harassment-laws-in-need-of-review-20180313-p4z47x.html">numerous</a> <a href="http://www.abc.net.au/radio/programs/am/gps-the-front-line-in-reporting-domestic-violence/4454916">media outlets</a> and <a href="https://honey.nine.com.au/2018/03/08/09/44/international-womens-day-ipsos-domestic-abuse-sexual-harassment">advocacy groups</a>. </p>
<p>But the One in Three Campaign, an advocacy group focused on the male victims of family violence, says these statistics are misleading.</p>
<p>Who is correct?</p>
<h2>Checking the sources</h2>
<p>In response to The Conversation’s request for sources, a spokesperson for The Age pointed The Conversation to <a href="https://www.vichealth.vic.gov.au/our-work/preventing-violence-against-women">the website</a> of the Victorian health promotion agency, VicHealth.</p>
<p>A VicHealth spokesperson told The Conversation VicHealth’s 2004 report <a href="https://www.vichealth.vic.gov.au/search/the-health-costs-of-violence">The health costs of violence: Measuring the burden of disease caused by intimate partner violence</a> focused on Victorian women aged 15 to 44.</p>
<p>Australia’s National Research Organisation for Women’s Safety (ANROWS) did a <a href="https://anrows.org.au/resources/news/further-examination-the-burden-disease">follow-up report in 2016</a> using similar methodology, but on a national scale. The <a href="http://media.aomx.com/anrows.org.au/s3fs-public/28%2010%2016%20BOD%20Compass.pdf">ANROWS report</a> focuses on Australian women aged 18 to 44, which corresponds to The Age’s statement. </p>
<p>A spokesperson for the One in Three Campaign pointed to the Australian Institute of Health and Welfare (AIHW) <a href="https://www.aihw.gov.au/reports/burden-of-disease/burden-of-disease-injury-australia-2003/contents/table-of-contents">Australian Burden of Disease Study 2003</a> (the current source cited on their website). The spokesperson also pointed to the more recent <a href="https://www.aihw.gov.au/reports/burden-of-disease/abds-impact-and-causes-of-illness-death-2011/data">Australian Burden of Disease Study 2011</a>.</p>
<p>You can read the full response from The One in Three Campaign <a href="https://theconversation.com/full-response-for-a-spokesperson-for-the-one-in-three-campaign-for-a-factcheck-on-domestic-violence-statistics-94894">here</a>.</p>
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<h2>Verdict</h2>
<p>The Age editorial used the words “leading preventable <em>cause</em> of death and illness for women aged 18 to 44”. This is incorrect. </p>
<p>It’s important to make a distinction between <em>cause</em> and <em>contributor</em> to death and illness.</p>
<p>If The Age editorial used the words “contributor to”, it would be correct, i.e. “leading preventable <em>contributor to</em> death and illness for women aged 18 to 44”.</p>
<p>The One in Three Campaign has correctly quoted the AIHW <a href="https://www.aihw.gov.au/reports/burden-of-disease/burden-of-disease-injury-australia-2003/contents/table-of-contents">Australian Burden of Disease Study 2003</a>. But it is not accurate to say the 2003 report is the “latest available data”, as the <a href="https://www.aihw.gov.au/getmedia/d4df9251-c4b6-452f-a877-8370b6124219/19663.pdf.aspx?inline=true">Australian Burden of Disease Study 2011</a> is the most recent data. </p>
<p>The findings, however, did not change a great deal between the 2003 and 2011 Australian Burden of Disease reports, in terms of the top causes of death, injury and illness. </p>
<p>If One in Three used the words “previous and current data shows”, and updated its reference, the claim would be correct.</p>
<p>While both of these claims are close to being correct, neither is complete. </p>
<hr>
<h2>Cause versus contributor</h2>
<p>To give the full picture of how domestic violence is related to death, injury and illness, we need to look at causes of death, injury and illness, <em>and</em> the contributors to those causes. </p>
<p>If we were talking about lung disease, for instance, we would treat that as a “cause” of illness, but we would also consider whether a person was a heavy smoker (a contributor). </p>
<p>Likewise, if we were to look at the number of people whose deaths were due to type 2 diabetes (the cause), we would be interested in knowing whether those people had an unhealthy diet (a contributor). </p>
<p>Intimate partner violence can be treated as either a cause of death, injury and illness in its own right (as a subset of violence), or a contributor to other causes, such as depression and anxiety. </p>
<p>Intimate partner violence can be a leading <em>contributor</em> to death, injury and illness among women, without being among the leading <em>causes</em>. Looking at it from one perspective alone doesn’t provide a complete picture. </p>
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<p>
<em>
<strong>
Read more:
<a href="http://theconversation.com/factcheck-is-there-a-link-between-early-and-easier-access-to-violent-tv-and-domestic-violence-51461">FactCheck: is there a link between early and easier access to violent TV and domestic violence?</a>
</strong>
</em>
</p>
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<h2>One in Three: causes of illness and death</h2>
<p>The claim by the One in Three Campaign is based on the AIHW <a href="https://www.aihw.gov.au/reports/burden-of-disease/burden-of-disease-injury-australia-2003/contents/table-of-contents">Australian Burden of Disease Study 2003</a>. This looks at the burden of death, injury and illness for all Australians, as well as providing breakdowns by age and sex. </p>
<p>The 2003 AIHW report is not the latest available data but the more recent <a href="https://www.aihw.gov.au/getmedia/d4df9251-c4b6-452f-a877-8370b6124219/19663.pdf.aspx?inline=true">Australian Burden of Disease Study 2011</a> contains basically the same results, in terms of the top causes of death, injury and illness. </p>
<p>The report used a range of data sources to look at different types of death, injury and illness, and considered how each of those contributed to the total “burden of disease”. </p>
<p>The “burden of disease” is based on a calculation of the number of years lost across a specified population due to premature death and years of “healthy” life lost due to disability arising from injury or illness. These years are called “disability-adjusted life years”. </p>
<p>According to that report, intimate partner violence was not among the top causes of death for women. Homicide and violence is the 26th highest cause of death, disability and illness.</p>
<p>The One in Three Campaign talked about the top five <em>causes</em> of death, disability and illness. The illnesses they referred to were the leading causes of “disability-adjusted life years”. </p>
<p>So this claim is about intimate partner violence as a <em>cause</em> of death, injury and illness rather than as a <em>contributor</em> to other causes.</p>
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<hr>
<p>It is important to note, however, that the 2003 AIHW report also estimated the contribution of intimate partner violence to the development of burdens such as depression and anxiety. </p>
<p>The report found intimate partner violence to be a leading risk for the development of depression and anxiety. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="http://theconversation.com/factcheck-qanda-is-domestic-violence-in-australia-on-the-decline-54043">FactCheck Q&amp;A: is domestic violence in Australia on the decline?</a>
</strong>
</em>
</p>
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<h2>The Age: contributors to illness and death</h2>
<p>The Age appears to be referring to a 2016 report commissioned by the not-for-profit group <a href="https://anrows.org.au/">Australia’s National Research Organisation for Women’s Safety</a> (ANROWS), which superseded the 2004 VicHealth <a href="https://www.vichealth.vic.gov.au/search/the-health-costs-of-violence">burden of disease</a> report. </p>
<p>The ANROWS report, <a href="http://media.aomx.com/anrows.org.au/s3fs-public/28%2010%2016%20BOD%20Compass.pdf">Examination of the burden of disease of intimate partner violence against women in 2011: Final report</a>, examined the prevalence and health impacts of intimate partner violence on Australian women. It found intimate partner violence and emotional abuse, in both cohabiting and non-cohabiting relationships:</p>
<blockquote>
<p>contributes more to the [disease] burden than any other risk factor in women aged 18-44 years, more than well known risk factors like tobacco use, high cholesterol or use of illicit drugs.</p>
</blockquote>
<p>The ANROWS report draws very strongly on methods and data used in the AIHW Australian Burden of Disease Study 2011, and focuses on intimate partner violence victimisation as a risk factor for death and other outcomes, such as mental and physical illness. </p>
<p>In other words, The Age claim is based on a report looking at the <em>contribution</em> of intimate partner violence to other causes of death, injury and illness – rather than as a cause in itself.</p>
<p>The report suggests intimate partner violence contributes to around 5.1% of the total “burden of disease” among women aged 18-44, making it the largest single contributor to the “burden of disease” for that group of women.</p>
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<p>The estimates reported are generally similar to other estimates (including those provided by AIHW reports) in terms of the magnitude of the burden, the diseases contributing to it and its ranking among other risk factors. </p>
<p>However, they may be slightly different due to the ANROWS report using a broad definition of intimate partner violence which includes emotional, as well as physical, abuse.</p>
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<p>
<em>
<strong>
Read more:
<a href="http://theconversation.com/factcheck-are-up-to-21-fathers-dying-by-suicide-every-week-87308">FactCheck: are 'up to 21 fathers' dying by suicide every week?</a>
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</em>
</p>
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<h2>Different perspectives</h2>
<p>Both claims rest on information drawn from very similar sources: the AIHW Burden of Disease Study 2011 and the previous study from 2003. Although all datasets and methods come with caveats and cautions, there is no reason to believe that those sources are inaccurate.</p>
<p>The inconsistency between the claims arises from different ways of looking at the question, and different interpretations of essentially the same data. </p>
<p>Based on the reports above, a more accurate thing to say is that although intimate partner violence is not a leading <em>cause</em> of death, injury and illness among Australian women aged 18-44, it does appear to be a leading <em>contributor</em>. – <strong>Samara MacPhedran</strong></p>
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<h2>Blind review</h2>
<p>I agree with the conclusions of this FactCheck. It is a balanced examination of the alternative claims about the impact of domestic violence on women’s health, and highlights the differences in the direct claims of causation, as against the more indirect claims of contribution.</p>
<p>The FactCheck also rightly highlights that the definition of domestic violence has been expanded widely to move beyond physical violence, to capture more abstract forms such as emotional, psychological and financial abuse. – <strong>Terry Goldsworthy</strong></p>
<p><em>* This article has been updated after publication to clarify the data in the first chart.</em></p>
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<img alt="" src="https://images.theconversation.com/files/212382/original/file-20180328-109169-1er5jzb.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip">
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<span class="caption">The Conversation FactCheck is accredited by the International Fact-Checking Network.</span>
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<p><em>The Conversation’s FactCheck unit is the first fact-checking team in Australia and one of the first worldwide to be accredited by the International Fact-Checking Network, an alliance of fact-checkers hosted at the Poynter Institute in the US. Read more <a href="https://theconversation.com/the-conversations-factcheck-granted-accreditation-by-international-fact-checking-network-at-poynter-74363">here</a>.</em></p>
<p><em>Have you seen a “fact” worth checking? The Conversation’s FactCheck asks academic experts to test claims and see how true they are. We then ask a second academic to review an anonymous copy of the article. You can request a check at <a href="mailto:checkit@theconversation.edu.au">checkit@theconversation.edu.au</a>. Please include the statement you would like us to check, the date it was made, and a link if possible.</em></p><img src="https://counter.theconversation.com/content/94102/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Samara McPhedran receives funding from the Commonwealth of Australia through its Criminology Research Grant scheme (CRG 11/16-17).</span></em></p><p class="fine-print"><em><span>Terry Goldsworthy is affiliated with the Gold Coast Centre Against Sexual Violence.</span></em></p>Are claims that intimate partner violence is the leading cause of death for Australian women aged 18-44 substantiated?Samara McPhedran, Senior Research Fellow, Violence Research and Prevention Program, Griffith UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/928192018-03-05T23:46:21Z2018-03-05T23:46:21ZInternational Women's Day: Reminder women must keep fighting — everywhere<figure><img src="https://images.theconversation.com/files/208820/original/file-20180304-65525-f7lk30.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">On International Women&#39;s Day in 2016, a demonstrator carries a cross that reads in Spanish: &quot;For you, for all&quot; to protest violence against women. International Women&#39;s Day is much more widely celebrated in Latin America than it is in Canada and the United States, but injustices for women is a global phenomenon. </span> <span class="attribution"><span class="source">(AP Photo/Eduardo Verdugo)</span></span></figcaption></figure><p><a href="https://www.internationalwomensday.com/">International Women’s Day</a> is a major global event that will be widely celebrated in some countries and virtually ignored in others.</p>
<p>In Latin America, <em>el Día Internacional de la Mujer</em> is important. It is popularly observed in most if not all countries by women and men from all walks of life. </p>
<p>On March 8, I will receive countless messages from friends and colleagues in Cuba and Guatemala, two countries where I have spent a considerable amount of time and maintain close personal and professional relationships. </p>
<p>Women — young, old, politically engaged or blissfully disinterested in politics — will congratulate me and other women on “our day.” </p>
<p>Yet in Canada, I feel International Women’s Day (IWD) is largely irrelevant. In fact, I was unaware of it until I started spending large chunks of time in Latin America. I have never had anyone in Canada or the United States wish me a Happy International Women’s Day. It just doesn’t seem to resonate in the same way that it does in Latin America. </p>
<p>Why is this the case? </p>
<h2>The importance of the UN</h2>
<p>It’s likely attributable to the different contexts in which IWD takes place, and the different political and cultural meanings that the day of celebration and protest has assumed.</p>
<p>The first IWD <a href="http://www.un.org/en/events/womensday/history.shtml">was celebrated in New York City in 1909</a> to commemorate the march for women’s rights that had taken place in that same city the previous year. </p>
<p>These activities were part of the struggle for women’s suffrage, which was slowly extended to women around the world in the early 20th century. They were also part of the broader struggle for women’s labour and economic rights, an agenda that was likely viewed by governments and citizens alike as communist propaganda. </p>
<p>The first IWD celebrations in New York were encouraged by the Socialist Party of America. From 1910 to 1917, IWD observances were held in Denmark, Germany, Finland, Austria, and Russia, among other places, mainly as the result of union and social democratic party activism. </p>
<p>Then, several decades later in 1975, the year of the first United Nations (UN) Conference on Women, the UN began an annual recognition and celebration of IWD.</p>
<p>The significance of the UN’s involvement is undeniable for countries in Latin America and for women’s movements in that region. Many activists within global and Latin American women’s movements credit the UN and its declarations and conferences for improvements in women’s rights and addressing gender discrimination. </p>
<p>The UN’s resources have enabled women to pressure otherwise unresponsive governments for social and political change. The UN, however, has not played a similar role in Canada and the United States.</p>
<h2>#MeToo and #TimesUp</h2>
<p>The UN continues to be the main global advocate of IWD. It organizes activities and highlights the continued struggle for women’s rights and gender justice. </p>
<p>The 2018 theme is <a href="http://www.un.org/en/events/womensday/index.shtml">“Time is Now: Rural and Women’s Activists Transforming Women’s Lives.”</a> It connects women’s struggles to the UN’s sustainable development goals and states that: “International Women’s Day is a time to reflect on progress made, to call for change and to celebrate acts of courage and determination by ordinary women who have played an extraordinary role in the history of their countries and communities.” </p>
<p>This recognizes a prolonged and communal struggle for women, one that is reflective of historical and continued experiences of women in Latin America.</p>
<p>For women in North America, current experiences are perhaps better captured in the explanation on the UN Women website that IWD 2018 “comes on the heels of unprecedented global movement for women’s rights, equality and justice.”</p>
<p><a href="http://www.unwomen.org/es/news/in-focus/international-womens-day">It notes that</a> the movement “has taken the form of global marches and campaigns, including #MeToo and #TimesUp in the United States of America and their counterparts in other countries, on issues ranging from sexual harassment and femicide to equal pay and women’s political representation.” </p>
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<span class="caption">Women in South Korea march on March 4, 2018, in support of the #MeToo movement in advance of 2018 International Women’s Day on March 8.</span>
<span class="attribution"><span class="source">(AP Photo/Ahn Young-joon)</span></span>
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<p>While this is a timely and engaging articulation of the theme, it is focused on very recent and highly contested political events, and suggests that the struggle for gender justice is fractured and individualized.</p>
<p>It’s also interesting to note that there is a competing global IWD campaign, supported not by the UN but by a conglomerate <a href="https://www.internationalwomensday.com/Theme">of corporate and non-governmental organizations.</a> Its theme is #PressForProgress, which is a fairly diluted call to action, one that is aimed primarily at women in countries of what’s now known as the <a href="https://www.rgs.org/NR/rdonlyres/6AFE1B7F-9141-472A-95C1-52AA291AA679/0/60sGlobalNorthSouthDivide.pdf">Global North.</a></p>
<h2>High rates of femicide in Latin America</h2>
<p>The importance of the UN, the significance of its sustainable development goals and the cultural understanding of enduring historical struggles for peace, justice and human and women’s rights in Latin America culminate in annual IWD celebrations. </p>
<p>Women in Latin America are aware that progress toward justice is hard won, and that there is much work left to be done. Latin America has some of the world’s highest rates of femicide. The epidemic of gender-based killing of women has inspired <a href="http://www.unwomen.org/en/news/stories/2017/2/take-five-adriana-quinones-femicide-in-latin-america">its own social movement</a>, #NiUnaMas.</p>
<p>In Canada and the U.S., these problems may not be seen as acute, which sometimes results in a tendency to view progress toward gender justice uncritically and to believe the myth of equal status. </p>
<p>But women everywhere have low status relative to men. This is a global phenomenon and there are no exceptions. There are, of course, individual women who defy this gender subordination, but women as a social category do not.</p>
<p>The problems that serve as evidence of women’s low status in Canada include the <a href="http://www.cbc.ca/news/business/statistics-canada-gender-pay-gap-1.4014954">gender pay gap</a>, the double burden of paid employment and household work, lack of affordable child care, sexual harassment and sexual assault. They extend to intimate partner violence, femicide, and <a href="https://www.thestar.com/news/gta/2018/03/03/toronto-protesters-demand-justice-for-tina-fontaine-and-other-indigenous-girls.html">missing and murdered Indigenous women</a>. </p>
<p>There is much work to be done in Canada. There is much work to be done everywhere. </p>
<p>The time is now.</p><img src="https://counter.theconversation.com/content/92819/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Candace Johnson receives funding from The Social Sciences and Humanities Research Council.</span></em></p>Women everywhere have low status relative to men. This is a global phenomenon and there are no exceptions, and there is much work to be done in Canada and everywhere. The time is now.Candace Johnson, Professor of Political Science, University of GuelphLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/875792017-11-26T19:09:31Z2017-11-26T19:09:31ZAustralia should be cautious about introducing laws on coercive control to stem domestic violence<figure><img src="https://images.theconversation.com/files/196253/original/file-20171124-21831-16erjf2.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Australian authorities should be caution when considering any new laws against coercive control.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Numerous Australian reviews – including Victoria’s <a href="http://www.rcfv.com.au">Royal Commission into Family Violence</a> and Queensland’s <a href="https://www.communities.qld.gov.au/gateway/end-domestic-family-violence/about/not-now-not-ever-report">Not Now, Not Ever Report</a> – have documented the failure of the criminal law to provide justice for victims of intimate partner violence. </p>
<p>A common question emerging from these reviews has been: how valuable is the introduction of new legal categories as a way of improving responses to intimate partner violence? </p>
<p>Drawing on the English experience in introducing the offence of <a href="https://www.gov.uk/government/news/coercive-or-controlling-behaviour-now-a-crime">coercive control</a>, we dissect this question. In doing so, we urge caution to those Australian jurisdictions contemplating a move in this direction.</p>
<h2>The English offence of coercive and controlling behaviour</h2>
<p>In 2015, a new offence of “controlling or coercive behaviour” was introduced in England and Wales. </p>
<p>Section 76 of the <a href="http://www.legislation.gov.uk/ukpga/2015/9/contents/enacted">Serious Crime Act 2015</a> states that a person commits coercive control if:</p>
<blockquote>
<p>a) A repeatedly or continuously engages in behaviour towards another person (B) that is controlling or coercive;</p>
<p>b) At the time of the behaviour, A and B are personally connected;</p>
<p>c) The behaviour has a serious effect on B; and</p>
<p>d) A knows or ought to know that the behaviour will have a serious effect on B.</p>
</blockquote>
<p>The offence, as legally defined, is gender-neutral and limited to behaviour between persons in a current intimate relationship. It covers a wide range of behaviours and draws directly on <a href="https://global.oup.com/academic/product/coercive-control-9780195384048?cc=au&amp;lang=en&amp;">the work of</a> American sociologist and forensic social worker Evan Stark.</p>
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<p>
<em>
<strong>
Read more:
<a href="http://theconversation.com/do-we-need-a-new-offence-to-protect-victims-of-family-violence-from-psychological-harm-86830">Do we need a new offence to protect victims of family violence from psychological harm?</a>
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<p>There have been varied responses to the introduction of this offence. While it is not yet possible to evaluate empirically its implementation, given the limited case law to date, it is possible to set out the likely gaps between the intention of the legislation – to better prevent and respond to violence against women – and its impact in practice. </p>
<p>Reflecting on the UK experience, <a href="http://journals.sagepub.com/doi/full/10.1177/1748895817728561">our recently published research</a> explores why a new offence may not necessarily improve legal responses to intimate partner violence. </p>
<h2>Meeting the needs of victims</h2>
<p>The implementation of this offence relies upon victims being willing and able to involve police. This is problematic.</p>
<p><a href="https://www.women.nsw.gov.au/__data/assets/pdf_file/0004/280912/Reporting_Violence_to_the_Police_-_BOCSAR_survey.pdf">Research</a> has consistently found that women victims of intimate partner violence are hesitant to engage police. They fear gender bias, discrimination, not being believed, that the abuse will escalate following police intervention, or that they will be blamed for the abuse committed against them.</p>
<p>For women within a coercively controlled relationship, these barriers to seeking help are particularly insurmountable. Evidence from Evan Stark’s <a href="https://global.oup.com/academic/product/coercive-control-9780195384048?cc=au&amp;lang=en&amp;">own work</a> suggests women who have been coercively controlled are more likely to experience isolation and to lack social support networks and independent decision-making skills. </p>
<p>Thus the introduction of a new offence alone is unlikely to reduce the reluctance of women victims to engage the police. </p>
<h2>A problematic reliance on police understanding</h2>
<p>Victims who do contact the police are likely to come up against additional barriers to justice. </p>
<p>For example, the implementation of this offence relies on a police officer’s ability to identify the potential presence of coercive and controlling behaviour, elicit information from the victim and correctly assess that pattern of behaviour.</p>
<p>This requires that officers move away from assessing a particular “incident” and instead interpret a series of interrelated events and the harm that flows from these. </p>
<p>Effectively educating frontline police on the gender dynamics at play in coercive control situations and enhancing their ability to identify such behaviour will require a long-term commitment to specialist training. This has yet to happen in England. </p>
<h2>The difficulty of evidence of coercive control</h2>
<p>For cases that proceed beyond the policing stage and into the criminal courtroom, a key issue is how to prove coercion. The difficulties women victims face in documenting their abuse should not be overlooked. </p>
<p>The offence of coercive control focuses on a pattern of abusive behaviour. This may involve unremarkable acts that, when viewed in isolation, are not criminal. Rather, it is about analysing behaviour that forms a pattern of abuse.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="http://theconversation.com/victoria-leads-the-way-on-family-violence-but-canberra-needs-to-lift-its-game-74036">Victoria leads the way on family violence, but Canberra needs to lift its game</a>
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<p>So the very same barriers that have traditionally hindered women’s access to justice are likely to persist, despite the existence of a new offence. </p>
<p>As of December 2016, only <a href="http://onlinelibrary.wiley.com/doi/10.1111/hojo.12227/full">59 convictions</a> for this offence were reported in the national statistics, which is perhaps illustrative of some of the difficulties highlighted here.</p>
<h2>More law is not the answer</h2>
<p>Recourse to the law remains one of the central planks of policy responses to intimate partner violence. </p>
<p>In the case of coercive control, our research suggests more law of this kind is not the answer to improving those responses. We urge Australian jurisdictions to be cautious about following in the footsteps of our English counterparts. </p>
<p>There may be a place for coercive control in law. But we believe a more effective role for this concept may lie in better-informed expert testimony presented to the court in the case of very serious offences. </p>
<p>Law reforms should be evidence-based and informed by an understanding of the problems the reform seeks to address. Policymakers must also look beyond the criminal law as a “quick fix” to a long-standing social problem and instead strengthen civil remedies, service access and delivery.</p>
<hr>
<p><em>The National Sexual Assault, Family &amp; Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.</em></p><img src="https://counter.theconversation.com/content/87579/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kate Fitz-Gibbon is a member of the Monash Gender and Family Violence Research Focus Program (<a href="http://artsonline.monash.edu.au/gender-and-family-violence/">http://artsonline.monash.edu.au/gender-and-family-violence/</a>). Kate receives funding for family violence related research from the Australian Research Council, ANROWS, and Victorian Department of Health and Human Services. Kate is a member of the Victorian Government Expert Committee on Perpetrator Interventions. </span></em></p><p class="fine-print"><em><span>Jude McCulloch is a member of the Monash Gender and Family Violence Research Focus Program (<a href="http://artsonline.monash.edu.au/gender-and-family-violence/">http://artsonline.monash.edu.au/gender-and-family-violence/</a>). Jude receives funding for family violence related research from the Australian Research Council, ANROWS, the Victorian Department of Health and Human Services, Family Violence Victoria and the Australian Research Council. Jude is a member of the Victorian Government&#39;s Family Violence Prevention Taskforce.</span></em></p><p class="fine-print"><em><span>Sandra Walklate is Eleanor Rathbone Chair of Sociology at the University of Liverpool conjoint Chair of Criminology at Monash University Melbourne. She is a member of the Monash Gender and Family Violence Research Focus Program.</span></em></p>New laws are often seen as an answer in tackling intimate partner violence, but our research shows it is not always the best response.Kate Fitz-Gibbon, Senior Lecturer in Criminology, Monash UniversityJude McCulloch, Professor of Criminology, Monash UniversitySandra Walklate, Eleanor Rathbone Chair of Sociology, University of LiverpoolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/875852017-11-20T23:58:32Z2017-11-20T23:58:32ZThe Oasis brothers: Father's abuse explains feud, resilience could end it<figure><img src="https://images.theconversation.com/files/195512/original/file-20171120-18574-13jlukd.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">In this 2008 photo, Liam Gallagher of Oasis performs during a concert in Los Angeles. Noel is seen on the screen behind him. The brothers have a notoriously dysfunctional relationship. Could their father&#39;s documented abuse of their mother explain the animosity?</span> <span class="attribution"><span class="source">(AP Photo/Chris Pizzello)</span></span></figcaption></figure><p>Liam Gallagher was in Toronto recently to perform songs from his solo album. As I took in the show, it all came back: The epic battles, still ongoing, between the infamous Liam and his brother Noel of the hugely popular ‘90s rock band, Oasis.</p>
<p>Oasis topped the charts globally with hits that included <em>Champagne Supernova</em> and <em>Wonderwall</em>. I was a fan and still am — the band’s music stands the test of time, and the seemingly endless feuds between Noel and Liam continue to capture our attention.</p>
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<p>But 20 years after they first became rock 'n’ roll megastars, I have another take on the Gallagher brothers through my work as an associate professor of social work at the University of Toronto and lead investigator of <a href="http://makeresiliencematter.ca/">Make Resilience Matter</a>. Funded by the Social Sciences and Humanities Research Council, it is a research, policy and practice initiative about children exposed to domestic violence. </p>
<p>So what does Oasis have to do with it? </p>
<p>We are learning that resilience can help kids “come through the fire” of domestic violence — an important finding, given what the Gallagher brothers faced then, and what children still face today. We are also learning that the Gallagher brothers’ exposure to domestic abuse could go a long way to explaining their continuing animosity towards one another.</p>
<h2>Exposure to domestic violence equals abuse</h2>
<p>Noel and Liam witnessed their father physically and verbally attacking their mother — they still recall her pain and humiliation. Noel <a href="http://www.dailymail.co.uk/news/article-3166743/Look-anger-Noel-Gallagher-reveals-abuse-suffered-hands-violent-alcoholic-father-worry-parenthood.html">has also talked</a> about being beaten by his father. </p>
<p>However, through this adversity, I suggest that both brothers found escape — and, ultimately, resilience — through their music. Noel himself has stated that, as a teenager, the guitar he found lying around the house took him away from it all. </p>
<p><a href="https://www.theguardian.com/music/2017/jun/04/liam-gallagher-interview-rock-n-roll-saved-my-life-oasis-beady-eye">Music became the brothers’ lifeline.</a> Liam’s performance in Toronto showed that resilience in action. </p>
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<span class="caption">Liam Gallagher performs in Toronto on Nov. 23.</span>
<span class="attribution"><span class="source">David McDonald Photography</span></span>
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<p>Music, in fact, as one form of healthy escape — along with other factors and processes we’ve identified in our research — can help put children on a pathway to resilience.</p>
<p>Why should we be concerned? </p>
<p>Today in Canada, children as young as infants experience what the Gallagher boys lived through. Exposure to intimate partner violence (IPV) is a form of child abuse just like physical, sexual, emotional abuse and neglect. </p>
<p>The frequency of child abuse, including IPV exposure, has been well-established through large-scale studies in North America, such as the ground-breaking <a href="https://www.cdc.gov/violenceprevention/acestudy/index.html">Adverse Childhood Experiences (ACE) Study</a> in the United States. In Canada, exposure to IPV is the <a href="http://cwrp.ca/sites/default/files/publications/en/ois-2013_final.pdf">most frequently reported form of abuse</a>
with the latest Canadian census showing <a href="http://www.tandfonline.com/doi/full/10.1080/15379418.2016.1204581">children living with violence</a> in over half a million households.</p>
<h2>Noel credited music as helping him escape</h2>
<p>I shine a light on the Gallagher brothers’ story — as they themselves recount in their <a href="https://www.youtube.com/watch?v=E2oNRM8lhps">recent documentary,</a> <em>Oasis: Supersonic</em>, and through media interviews — not to draw attention to the over-the-top rock star antics portrayed in the media, but to make a point about children, resilience and domestic violence.</p>
<p>Growing up in a social housing estate in Manchester, England, and on probation for truancy and stealing at 13, Noel discovered music, saying that it was his escape from everything, no matter what was going on at home or school.</p>
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<p>Along with music, our research identifies other forms of “escape” such as sports, art, acting, writing and reading. As well, the strength and support of the boys’ mother Peggy, who ultimately left her husband with her sons, reflects another key finding in my research: Children need a safe, supportive adult/caregiver. </p>
<p>Through in-depth interviews with adults about their childhoods affected by IPV, we have gone on to identify <a href="http://makeresiliencematter.ca/wp-content/uploads/2017/04/MRM-Fact-Sheet-Summer2016.pdf">21 ways to resilience.</a></p>
<p>There’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887080/">significant research</a> that tells us children exposed to IPV are more likely to experience trauma, aggression, depression and difficulties managing and expressing their emotions appropriately. </p>
<p>Seeing your mother hurt and living in a fear-filled house where everyone walks on eggshells, as the Gallaghers did, can cast a long shadow into the future: When children are exposed during critical formative years, it not only immediately disrupts important cognitive, social and emotional development, <a href="http://www.ajpmonline.org/article/S0749-3797(07)00349-2/fulltext">it also affects relationships and pathways into adulthood.</a></p>
<p><a href="https://www.researchgate.net/publication/256489861_Siblings_exposed_to_intimate_partner_violence_Linking_sibling_relationship_quality_child_adjustment_problems">Research</a> is also beginning to show — and I will be delving into this more fully in my own research — how sibling relationships can be affected: Some siblings may become over-protective, others may become distant, and still others may be hostile.</p>
<p>The antagonistic relationship between Liam and Noel immediately springs to mind.</p>
<h2>Children can overcome their childhoods</h2>
<p>There is good news, however, for the Gallaghers and others who grew up in homes plagued by domestic violence. Children can overcome significant adversity — many have. But they, and everyone surrounding and supporting them, need to know one thing: Resilience is not innate. It is not something one child has and another doesn’t.</p>
<p>It can be developed and fostered. (Visit our site for a <a href="http://makeresiliencematter.ca/what-we-know/">full definition of resilience, with references</a>.)
Children who experience difficulties — sometimes severe problems — can adopt healthy relational behaviours, recover and follow healthy developmental trajectories.</p>
<p>Through our rigorous study of children and families facing extremely tough challenges surrounding domestic violence, we’ve found that resilience can be actively and intentionally promoted at three levels: The child, the child’s relationships and the context or the community that surrounds the child. </p>
<p>Many of these factors and processes can be developed, taught or strengthened by:</p>
<ol>
<li><p>Encouraging a skill or talent;</p></li>
<li><p>Providing outlets and resources for kids to play sports, make music, act, etc.;</p></li>
<li><p>Connecting kids with safe, supportive adults and positive role models;</p></li>
<li><p>Assisting mothers in their efforts to protect their children from further harm by increasing access to support, housing, education, employment;</p></li>
<li><p>Involving supportive extended family;</p></li>
<li><p>Helping children accurately assign responsibility for the abuse and break the cycle of violence.</p></li>
</ol>
<h2>‘Through the fire’</h2>
<p>For good reason, research and practice have focused largely on establishing the scope and addressing negative effects. </p>
<p>Now we’re learning that we need to more fully understand how children navigate their way “through the fire.” By better connecting the dots between children, intimate partner violence and resilience, we will improve how we identify and support resilience factors and processes for each and every child.</p>
<p>As for Liam and Noel Gallagher, there is still hope for their relationship. </p>
<p>Individually, they have navigated tremendous adversity. Despite their feuding via the media, <a href="https://www.spin.com/2017/10/noel-gallagher-liam-gallagher-twitter-accusations-response/">given the desire,</a> the right conditions and skilled intervention, there is still the possibility of reconciliation. Maybe their motivation could be what compels so many of us to do better — for our children.</p>
<p>For the Gallaghers, letting go of the anger and settling their differences might help stop the trauma and violence too often passed down from one generation to another — and encourage and support their own children’s resilience.</p>
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<p class="fine-print"><em><span>Ramona Alaggia receives funding from Social Sciences and Humanities Research Council of Canada. </span></em></p>The famous feuding Gallagher brothers of the rock band Oasis illustrate what research shows: Kids who grow up in homes where there is domestic violence often grow up to have troubled relationships.Ramona Alaggia, Associate Professor; Factor-Inwentash Chair in Children’s Mental Health, University of TorontoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/871872017-11-10T02:37:16Z2017-11-10T02:37:16ZWhy are rates of domestic violence in Australia still so high?<figure><img src="https://images.theconversation.com/files/194078/original/file-20171109-13351-1llgaiw.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">One in six Australian women have experienced partner violence.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/LoxQzNMvgYU">Isaac Holmgren/Unsplash</a></span></figcaption></figure><p>Australian Bureau of Statistics (ABS) data released this week as part of the <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4906.0%7E2016%7EMain%20Features%7EAbout%20the%20Personal%20Safety%20Survey%20%7E2">Personal Safety Study (PSS)</a> reveals 16% of Australian women have experienced partner violence. </p>
<p>The 2016 PSS was conducted across Australia and surveyed around 21,000 people about their experience of violence. The PSS was last run in 2012, and before that in 2005, so it’s possible to make some comparisons across time. </p>
<p>The statistics show a mixed picture. Overall, the proportion of Australians who report that they experienced violence in the past year has declined from 8.3% in 2005 to 5.4% in 2016.</p>
<p>However <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4906.0%7E2016%7EMain%20Features%7EExperience%20of%20Partner%20Violence%7E17">partner violence</a> remains high, especially towards women. </p>
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<p>Around one in six women (16% or 1.5 million) have experienced physical violence by a partner, compared with one in seventeen men (5.9% or 528,800). </p>
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<strong>
Read more:
<a href="http://theconversation.com/study-confirms-intimate-partner-violence-leading-health-risk-factor-for-women-67772">Study confirms intimate partner violence leading health risk factor for women</a>
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<p>Women were much more likely to experience physical violence from a previous partner than a current one. Around 2.9% of women reported violence by a current partner, while around 14.6% of women experienced violence by a previous partner. There has been <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4906.0%7E2016%7EMain%20Features%7EPrevalence%20of%20partner%20violence%20over%20time%7E19">little change</a> in the partner violence figures since 2005.</p>
<p>In the last few years, significant resources have been devoted to changing attitudes towards domestic violence – so why aren’t the numbers going down? </p>
<p>One answer may be that broader attitudes towards women and relationships need to change and this takes a long time. Campaigns like <a href="https://www.youtube.com/watch?v=fLUVWZvVZXw">Let’s Change the Story</a> and <a href="https://www.theline.org.au/">The Line</a> focus on creating the deep and long-lasting cultural change that’s needed but it’s probably still too early to see results.</p>
<p>Another answer might be that some people are changing, and using violence less. But as we talk more about domestic violence, it loses the stigma historically attached to it. As a consequence, more people are prepared to name it and report it. This keeps the figures stable.</p>
<p>The ABS statistics show that some women* report violence by their intimate partners after separation rather than during the relationship. Of the women who reported experiencing domestic violence, 92.4% were living with their partner and 7.6% were separated.</p>
<p>This is no surprise. Leaving the relationship may threaten an <a href="http://journals.sagepub.com/doi/abs/10.1177/1748895817728380">abuser’s sense of control</a> and violence may be one tactic used in an effort to reassert control or punish the victim for leaving. </p>
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<p>
<em>
<strong>
Read more:
<a href="http://theconversation.com/why-doesnt-she-just-leave-the-realities-of-escaping-domestic-violence-29537">Why doesn't she just leave? The realities of escaping domestic violence</a>
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<p>In 1990, Martha Mahoney coined the term <a href="http://repository.law.miami.edu/cgi/viewcontent.cgi?article=1388&amp;context=fac_articles">“separation assault”</a> in recognition of the phenomenon. Separation is now a well-known risk factor for heightened violence. In <a href="http://www.courts.qld.gov.au/__data/assets/pdf_file/0003/541947/domestic-and-family-violence-death-review-and-advisory-board-annual-report-2016-17.pdf">government</a> <a href="http://www.coroners.justice.nsw.gov.au/Documents/2015-2017_FINAL%20with%20proper%20cover_311017.pdf">death reviews</a>, actual or intended separation is a characteristic of a high proportion of intimate partner homicides. </p>
<p><a href="http://dfvbenchbook.aija.org.au/dynamics-of-domestic-and-family-violence/factors-affecting-risk/or">Risk assessment tools</a> that police and support services use in safety planning now routinely identify separation as a key risk factor for further violence and death.</p>
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<span class="caption">As we reduce the stigma of naming domestic violence we may see more women seek help.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/TOfxVzsuaKc">Annie Spratt/Unsplash</a></span>
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<p>Notably, while the ABS statistics have remained relatively stable, calls on services have increased significantly over recent years. Applications for domestic violence protection orders in Queensland have jumped from 23,794 in <a href="http://www.courts.qld.gov.au/__data/assets/pdf_file/0009/216279/mc-ar-2012-2013.pdf">2012-13</a> to 32,221 in <a href="http://www.courts.qld.gov.au/__data/assets/pdf_file/0005/498461/mc-ar-2015-2016.pdf">2015-16</a> – a 26% rise. </p>
<p>Similarly in Victoria, 74,551 family violence and personal safety matters were heard by the <a href="https://www.magistratescourt.vic.gov.au/sites/default/files/MCV%20AR%2015-16%20%28final%29.pdf">Victorian Magistrates Court</a> in 2015–16. This was a 27% increase since 2011–12. </p>
<p>In Queensland, reports to police of breach of domestic violence protection orders have more than doubled between <a href="https://www.police.qld.gov.au/rti/published/about/Crime+Statistics.htm">2012 and 2017</a> and these have also increased significantly <a href="http://www.police.vic.gov.au/content.asp?a=internetBridgingPage&amp;Media_ID=72311">in Victoria</a>. </p>
<p>According to annual reports, calls for support to Queensland’s domestic violence support line, DVConnect, have tripled between <a href="http://www.dvconnect.org/wp-content/uploads/2015/03/DV-CONNECT-AR-2012-13-FINAL-with-Charts.pdf">2012</a> and <a href="http://www.dvconnect.org/wp-content/uploads/2015/03/DV-CONNECT-Annual-Report-2015-16.pdf">2016</a>. <a href="https://view.publitas.com/websetgo/ssfvc-1516-annual-report/page/24-25">Safesteps</a>, Victoria’s domestic violence support line, has seen a similar increase.</p>
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<p>
<em>
<strong>
Read more:
<a href="http://theconversation.com/deaths-after-seeking-help-point-to-priorities-in-tackling-domestic-violence-47421">Deaths after seeking help point to priorities in tackling domestic violence</a>
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<p>Given the ABS reports that figures on domestic violence remain relatively stable, why is there such an increase in requests for support and services? </p>
<p>The ABS statistics are collected through a survey and include questions about seeking help.</p>
<p>The increased numbers of applications for protection orders, reports of breach of those orders and increased calls to support services might suggest that people are increasingly willing to seek help in response to the violence they are experiencing. </p>
<p>Perhaps some are choosing to leave their violent partners. Again, this increase in help-seeking may be explained in part by a reduced stigma associated with domestic violence and the increased willingness of people to name it. </p>
<p>Another explanation might be that services are improving their understanding of domestic violence and are getting better at <a href="http://www.health.nsw.gov.au/kidsfamilies/protection/Pages/DVRS.aspx">screening for domestic violence</a> and making appropriate referrals.</p>
<p>Whatever the reason for them, the relative stability of the overall statistics in the ABS study leave no room for complacency. The figures remain too high. </p>
<p>As we reduce the stigma of naming domestic violence we may see more women seek help, and when they do they will often be placing themselves at serious risk. We need to continue to develop and resource robust responses to individual perpetrators and appropriate support for victims.</p>
<hr>
<p><em>The National Sexual Assault, Family &amp; Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.</em></p>
<p><em>* This article originally said higher number numbers of women reported violence by their intimate partners after separation than during the relationship. This has now been corrected. The article also been amended to reflect that the ABS survey included questions about help-seeking.</em></p><img src="https://counter.theconversation.com/content/87187/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Douglas receives funding from the Australian Research Council (FT140100796) She is affiliated with DVConnect. </span></em></p>In the last few years, significant resources have been devoted to changing attitudes towards domestic violence – so why aren’t the numbers going down?Heather Douglas, Professor of Law, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/857072017-10-16T14:50:02Z2017-10-16T14:50:02ZAttitudes to women who have more than one abortion need to change<figure><img src="https://images.theconversation.com/files/190383/original/file-20171016-30954-1m6xbvn.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/girl-sitting-alone-on-wooden-bridge-735033322">Shutterstock</a></span></figcaption></figure><p>One in three women in the UK will have an abortion in her lifetime. But despite being a common medical procedure, abortion – which was partially legalised 50 years ago this month – continues to be stigmatised in the media and elsewhere in many different ways, meaning it is rarely talked about.</p>
<p>One abortion may be viewed as a reasonable “get out of jail free” card; having more than one abortion is often presented as beyond the pale. A woman might be able to decide she cannot continue with a pregnancy once, but to do so more than once speaks of her irresponsibility, fecklessness and failure to use contraception. </p>
<p>We recently carried out <a href="http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.14940/epdf">research</a> on women in Scotland who’d had more than one abortion. Our findings highlighted some <a href="http://www.sphsu.mrc.ac.uk/wema-plain-language-summary.pdf">key barriers</a> faced by women seeking abortions, which fail to be recognised because of commonly-held assumptions. These relate to problems with contraception, <a href="http://apps.who.int/iris/bitstream/10665/77432/1/WHO_RHR_12.36_eng.pdf">intimate partner violence</a>, life aspirations and social or economic disadvantage. And what do these problems have in common? They are all factors over which a woman may have little or no control, and which are compounded by feelings of shame and stigma.</p>
<h2>Problems with contraception</h2>
<p>Finding the right contraceptive can be difficult for some women; options remain relatively limited, and side effects can be disruptive and offputtingly grim. Plus, contraception does not always work, and the burden of trying to ensure that it does continues to fall disproportionately to women.</p>
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<span class="caption">The burden of finding a contraceptive method that works best still falls disproportionately on women.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/birth-control-pill-contraceptive-condom-702610129">Shutterstock</a></span>
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<p>What some may find most surprising is that most women in our study were using contraception when they became pregnant – particularly those who had undergone a previous abortion. For most interviewees it was the failure of condoms or the pill that resulted in their most recent pregnancy. Many had tried other “<a href="https://www.fpa.org.uk/contraception-help/long-acting-reversible-contraception-larc">long acting</a>” methods, such as contraceptive implants or intrauterine devices in the past, but had experienced problems. What this suggests is that women are not treating abortion “like contraception”, but are having problems finding a method that suits and works for them and their partner. </p>
<h2>Domestic violence</h2>
<p>The link between intimate partner violence and abortion has long been acknowledged, and abortion clinic staff are trained to look out for signs of an abusive relationship. We found that for many women seeking more than one abortion, experiences of violent or controlling relationships were common and contributed to their decision to end a pregnancy on at least one occasion. </p>
<p>For some, this included partners refusing to use condoms or let the woman use the pill. For others, escalating physical violence led to the termination of a planned pregnancy, or meant that abortion was the only way to break ties with an aggressive or violent man. </p>
<h2>Aspirations and disadvantage</h2>
<p>Reproductive rights advocates often point out that the power to decide if and when to have a pregnancy is fundamental to gender equality. Women need to be able to decide if and when they want to be pregnant in order to have the kinds of lives that they want. </p>
<p>Issues relating to life aspirations and social or economic disadvantage loomed large in women’s decisions to seek abortion more than once, with many citing not having their own home, still being in full-time education and career or other life ambitions as reasons they did not want to be pregnant. Their experiences suggested that caring commitments, concerns about existing children, and financial instability were also significant factors. </p>
<h2>‘Here I am again’</h2>
<p>The fact that women may increasingly be trying to obtain abortion medications via the internet <a href="http://www.thedebrief.co.uk/news/real-life/british-women-are-using-abortion-pills-due-to-difficulty-accessing-clinics-20170968296">has recently received attention</a>. For some women we spoke to, this was the case primarily because they felt so uncomfortable about having to return to their local abortion service, admit that it had happened again and face what they believed would be negative judgement from health professionals. For some who did return to services, this attitude was all too real.</p>
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<span class="caption">Relationships with violent partners can often lead to abortion if a woman fears for the safety of a child.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/domestic-violence-family-conflict-concept-sadness-721738633">Shutterstock</a></span>
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<p>Beyond those who sought options online, many women we spoke to had also experienced significant health problems prior to their pregnancies, including severe anxiety and depression. Their need to prioritise their own health had contributed to their decisions to seek abortion. Unfortunately, feelings of shame arising from the stigma around abortion had in turn had a negative impact on their mental well-being in the short term. For some, this meant they felt unable to talk to friends or family, even when they had been previously supportive, for fear of being judged for making the same “mistake” again.</p>
<p>What this all points to is that there needs to be less focus on how many abortions women have and less judgement of those seeking more than one. Instead we need greater focus on the gender inequalities which result in women bearing the brunt of pregnancy prevention and experiencing violence in intimate relationships.</p>
<p>No woman should be deemed irresponsible, feckless, or a failure for needing more than one abortion. And no woman should see her life aspirations, physical or mental health stymied by pregnancies she does not want or feel able to continue.</p><img src="https://counter.theconversation.com/content/85707/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Carrie Purcell&#39;s current work is funded by The Scottish government and the National Institute for Health Research. </span></em></p>Women have further abortions are not treating it "like contraception" but have good reasons that are often beyond their controlCarrie Purcell, Research Associate, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, University of GlasgowLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/818672017-08-23T15:45:15Z2017-08-23T15:45:15ZWhy home, even when there's war, is the most dangerous place for women<figure><img src="https://images.theconversation.com/files/183130/original/file-20170823-13293-ha7usf.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Congolese women in the eastern town of Bunia. Even in conflict zones women are more likely to face violence in their homes than outside.</span> <span class="attribution"><span class="source">EPA/Murizio Gambarini</span></span></figcaption></figure><p>After decades of advocacy, a <a href="https://www.gov.uk/government/topical-events/sexual-violence-in-conflict">global summit</a> was finally convened in London three years ago to find a way of ending sexual violence in conflict situations. The aim was to focus attention on this often-overlooked aspect of warfare.</p>
<p>While this is right and good, over emphasising conflict-related sexual violence runs the risk of making us lose sight of the fact that a war zone is not the most dangerous place for a woman. Her home is.</p>
<p>Nearly a third <a href="http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdf">(30%) of women worldwide</a> in intimate relationships will experience violence at the hands of their partners. This is according to the World Health Organisation, the London School of Hygiene and Tropical Medicine and the South African Medical Research Council.
Globally, about <a href="http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdf">38% of all women murdered</a> die at the hands of their intimate partners.</p>
<p>South Africa is a case in point. According to a 2016 health and democratic <a href="http://www.statssa.gov.za/publications/Report%2003-00-09/Report%2003-00-092016.pdf">survey</a>, a fifth (21%) of women over 18 years old in intimate relationships have experienced physical violence from a partner; 6% experienced sexual violence from a partner. And a <a href="https://www.researchgate.net/profile/Shanaaz_Mathews/publication/26754902_Mortality_of_Women_From_Intimate_Partner_Violence_in_South_Africa_A_National_Epidemiological_Study/links/0fcfd510224ab97739000000/Mortality-of-Women-From-Intimate-Partner-Violence-in-South-Africa-A-National-Epidemiological-Study.pdf">retrospective national study</a> published in 2009 put the South African mortality rate from intimate partner violence at 8.8 per 100 000 women – twice as high as the USA.</p>
<p>Not that America is a safe place for women. The Centre for Disease Control’s 2010 National Intimate Partner and <a href="https://www.cdc.gov/violenceprevention/pdf/cdc_nisvs_ipv_report_2013_v17_single_a.pdf">Sexual Violence Survey</a> found that 9,4% of women have been raped by intimate partners in their lifetime. 15,9% of women have experienced sexual intimate partner violence other than rape, and nearly 33% of women have been subjected to physical violence at the hands of their partners. </p>
<p>Shocking new findings show that even in conflict-affected countries infamous for the high rates of sexual violence perpetrated by fighting forces and where soldiers and rebel fighters are a daily danger to women, their husbands and boyfriends are the bigger threat. A <a href="http://tilz.tearfund.org/%7E/media/files/tilz/sgbv/2017-tearfund-does-faith-matter-en.pdf?la=en">baseline household survey</a> done in the north-east of the Democratic Republic of Congo (DRC) showed that women reported very high levels of intimate partner violence – much higher than the rate of sexual violence perpetrated by soldiers and militias.</p>
<h2>DRC research</h2>
<p>The baseline household survey was done in 15 communities in the Ituri Province of the DRC and 769 people were interviewed.</p>
<p>It was conducted by <a href="http://www.tearfund.org/">Tearfund</a> and <a href="http://www.healafrica.org/">HEAL Africa</a> as part of a project called “Engaging with Faith Groups to Prevent Violence Against Women and Girls in <a href="http://www.whatworks.co.za/about/global-programme/global-programme-projects/innovation-projects/item/36-engaging-with-faith-groups-to-prevent-violence-against-women-and-girls-in-conflict-affected-communities">Conflict-affected Communities</a>”. This project is funded by UK aid from the UK government, via the What Works to Prevent Violence Against <a href="http://www.whatworks.co.za/">Women and Girls</a> Global Programme. The funds are managed by the South African Medical Research Council. </p>
<p>The eastern DRC is still racked by ongoing violence from different rebel groups. This has been going on for decades, and the eastern DRC is known for high rates of very violent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093280/">sexual attacks</a> perpetrated by soldiers as well as rebels.</p>
<p>The survey showed that non-partner sexual violence – which would include sexual violence perpetrated by soldiers and rebels – was very high – 20,8% of women reported non-partner sexual violence within the last year. This is much higher than the <a href="http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdf">global figure of 7%</a> for lifetime experience of non-partner sexual violence. </p>
<p>This outcome of the survey was expected. What wasn’t was the shocking finding that more than two thirds (68.7%) of the women who reported having experienced non-partner sexual violence in the last 12 months, said that the perpetrator was a known person or a family member. Only in 6% of the cases was the perpetrator a militia member or another unknown person.</p>
<p>As shocking was the very high levels of intimate partner violence: 68.8% of women in relationships who took part in the survey reported having experienced some form of intimate partner violence in the previous 12 months, and 38,4% had been sexually violated by an intimate partner in the last year. Over 68,2% of men in relationships reported perpetrating intimate partner violence.</p>
<h2>War versus the home</h2>
<p>While still under researched, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124472/">there is evidence suggesting</a> that intimate partner violence increases during times of conflict, is more common in couples that experienced or were affected by armed conflict. </p>
<p>Nevertheless, the survey confirms that, even in areas affected by conflict, intimate relationships are the biggest and most consistent threat to a woman’s safety. </p>
<p>What this underscores is that yes, there is need to address the abuses suffered by women at the hands of those waging war. But what musn’t be forgotten is that, for many women all over the world, their homes are the battle front.</p>
<p>Feminist theories explaining violence against women have gained increasing traction in the past few decades. They explain that such violence is a result of male power within <a href="https://libcom.org/files/Theorizing%20Patriarchy%20-%20Sylvia%20Walby.pdf">patriarchal society</a>, revealing the relationship between gender and power. Even sexual violence is about power, as through the act men aim to prove their dominance and control over women.</p>
<p>Addressing this imbalance in society is difficult. One possible avenue through which it can be done is religion and religious institutions. Religion is able to <a href="http://home.ku.edu.tr/%7Embaker/cshs503/durkheimreligiouslife.pdf">influence behaviour</a> and motivate and facilitate <a href="http://www.worldcat.org/title/protestant-ethic-and-the-spirit-of-capitalism/oclc/3064861">social change</a>. While research has shown us that religious institutions are usually <a href="http://www.tandfonline.com/doi/abs/10.1080/15570274.2016.1215837?journalCode=rfia20">patriarchal institutions</a>, upholding the status quo that is <a href="http://www.africansunmedia.co.za/portals/0/files/extracts/justice_not_silence_extract.pdf">detrimental to women</a>, the opposite can also be true. Tearfund and HEAL Africa, focusing on religious leaders to act as catalysts to prevent violence against women and girls in Ituri province, are banking on this.</p><img src="https://counter.theconversation.com/content/81867/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Elisabet le Roux consults for Tearfund UK as research lead on the project &quot;Engaging with Faith Groups to Prevent Violence Against Women and Girls in Conflict-affected Communities&quot;. </span></em></p>Shocking new findings show that even in conflict-affected countries where soldiers and rebel fighters are a daily danger to women, their husbands and boyfriends are the bigger threat.Elisabet le Roux, Researcher, Unit for Religion and Development Research, Faculty of Theology, Stellenbosch UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/790902017-06-26T22:29:25Z2017-06-26T22:29:25ZFears for pets can put abused women at further risk<figure><img src="https://images.theconversation.com/files/174572/original/file-20170619-22129-a38ukx.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Abused women were concerned that their pets may also be harmed by their abuser.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>As researchers looking into the <a href="http://www.uwindsor.ca/aipabuseresearchgroup/">intersection of abuse against people and animals</a>, we asked survivors of intimate partner violence in shelters across Canada about a normally pleasant topic: their pets.</p>
<p>Not surprisingly, many said they had strong bonds with their pets. However, many women also said their pets had been mistreated by their abusive partners. This made many of the women want to leave their abusers, but they were also worried that if they left, their pets would be harmed in their absence. </p>
<p>Not being able to take their pets with them to shelters meant the majority of women delayed leaving their abusive partners.</p>
<p>This is the intersection of animal abuse and intimate partner violence. </p>
<h2>Dangers for pets <em>and</em> women</h2>
<p>When we asked these women about how their pets were treated by their abuser, we found the animals were harmed and abused in many ways. Most research usually focuses on physical animal abuse, but we found that threats, emotional animal abuse and neglect were also common. In order to better measure this issue, we created the <a href="http://dx.doi.org/10.1080/08927936.2016.1228760">Partners’ Treatment of Animals Scale</a> to bring all these types of abuse and harm together. </p>
<p>We also looked at the <a href="http://journals.sagepub.com/home/jiv">relationship between pet abuse and the amount and extent of abuse experienced by women</a>. In our sample, more frequent and severe animal abuse was linked to women being at higher risk of severe psychological, physical and sexual abuse.</p>
<p>Not only is the security and well-being of pets at risk, but so is the health and safety of women and children. </p>
<h2>Shelter limitations</h2>
<p>Many shelters across the country have off-site programs to care for the pets of abused women. These are most commonly through partnerships with humane societies, other charitable organizations and veterinary clinics. </p>
<p>However, these programs have two main limitations. </p>
<p>First, often they can only care for the women’s pets for a short period of time. Second, they <a href="http://www.cbc.ca/news/canada/windsor/programs/windsormorning/domestic-violence-and-pets-1.4151632">require women – and their children – to be separated from their pets</a>, which is something most do not want to do. </p>
<p>We also found many women in our sample (48 per cent) were not told by staff about the off-site services available for their pets. And many of the women who were told about the services were only told after they were already at the shelter and had left their pets behind. </p>
<p>There are a few shelters in the country that allow women’s pets to come with them. These programs are not subject to the limitations discussed above. However, most shelters in the country do not currently have the resources and logistical information necessary to develop on-site pet programs. This means<a href="http://www.cbc.ca/player/play/963333699870">many women do not come to shelters because they cannot bring their pets</a> with them. </p>
<p>These limitations, combined with the high rate of co-occurrence between animal maltreatment and intimate partner violence (89 per cent in our sample), increase the risk of harm to both people and pets. Fifty-six per cent of our sample of abused women said they delayed leaving their abusive partners because they were worried about their pets’ well-being. Sixty per cent eventually did leave their pets with their abusive partners once they fled to a shelter. Further, about one-third of these women left shelters to return home to check on their pets, and were also thinking about reuniting with their abuser because he had their pets. </p>
<h2>Powerful bond</h2>
<p>We are currently finalizing our research with a national sample of shelter staff, as well as a sample representing the general public. This information will give us critical feedback about the unique needs that women with pets have and how to best help women and their pets escape abusive partners. It will also tell us about the prevalence of this problem among the general population, not just among women who have accessed shelters.</p>
<p>Our <a href="https://www.youtube.com/watch?v=e3xB9QX-J_0">goal</a> is to provide individuals and organizations working with survivors of intimate partner violence with data and support to establish on-site pet services at shelters across Canada. This will allow victims of abuse to seek help without concern for their pets’ safety, and without having to be separated from their pets during such a difficult time. </p>
<p>Not only might this save the lives of women who will not have to choose between the safety of their pets and themselves, but it can <a href="https://doi.org/10.1177/016059760703100405">protect the powerful bond between women and pets</a> – a bond that can help women survive violence and be resilient in the face of it.</p><img src="https://counter.theconversation.com/content/79090/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Fitzgerald receives funding from the Social Sciences and Humanities Research Council (SSHRC)</span></em></p><p class="fine-print"><em><span>Betty Jo Barrett has received funding from the Social Sciences and Humanities Research Council (SSHRC). </span></em></p><p class="fine-print"><em><span>Allison Gray ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d&#39;une organisation qui pourrait tirer profit de cet article, et n&#39;a déclaré aucune autre affiliation que son poste universitaire.</span></em></p>Concern for their pets' safety can lead women to delay leaving their abusers. Better on-site pet services in women's shelters would enable them to seek help without fear for their animals’ well-being.Allison Gray, Sociology, University of WindsorAmy Fitzgerald, Associate professor, University of WindsorBetty Jo Barrett, University of WindsorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/783522017-05-25T12:51:51Z2017-05-25T12:51:51ZGender-based violence in South Africa: what's missing and how to fix it<figure><img src="https://images.theconversation.com/files/170945/original/file-20170525-23230-1tawmse.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">A South African student invites people to &quot;walk in others&#39; shoes&quot; doing a protest about gender based violence.</span> <span class="attribution"><span class="source">EPA/Kim Ludbrook </span></span></figcaption></figure><p>Valencia Farmer was 14 years old when she was brutally <a href="http://ewn.co.za/2016/02/02/valencia-farmers-killer-handed-23-year-jail-term">gang raped and murdered</a>. She was stabbed 53 times. That was in 1999 and her killer was only sentenced for the crime 17 years later.</p>
<p>Sihle Sikoji was 19 years old and some men didn’t like the fact that she was a lesbian. So they stabbed her to death <a href="http://www.iol.co.za/news/crime-courts/lesbian-speared-to-death-by-gang-1421252">with a spear</a>.</p>
<p><a href="http://ewn.co.za/2013/10/31/The-Anene-Booysen-Story">Anene Booysen</a> was gang raped and disemboweled in 2013. Less than a month later athlete Oscar Pistorius shot and killed <a href="http://ewn.co.za/2017/02/14/family-remembers-reeva-steenkamp-four-years-after-fatal-shooting">Reeva Steenkamp</a> through a closed toilet door. </p>
<p>In May 2017, <a href="http://www.timeslive.co.za/sundaytimes/stnews/2017/05/14/Horrific-details-of-Karabo-Mokoenas-gruesome-murder-emerge">Karabo Mokoena</a> became the latest face of South Africa’s gender-based violence epidemic. She was killed and her body burned beyond recognition, allegedly by her ex-boyfriend.</p>
<p>People remember these gruesome cases that end up on newspapers’ front pages. These women’s stories come with a flare up of societal outrage, protest and collective introspection. Then South Africans live in hope for a while, believing that this time something might change. But nothing does in a country marked by unusually <a href="https://www.saps.gov.za/services/final-crime-stats-release-02september2016.pdf">high levels</a> of rape and femicide.</p>
<p>There is little fluctuation in these statistics, which are reported annually by the South African Police Services. What this means is that without political will, a change in the sensationalism and narratives around the reporting of gender based violence and men’s greater involvement as allies with women when it comes to gender based violence, nothing will change.</p>
<h2>Bad reporting, bad use of words</h2>
<p>One of the problems is how violence against women is reported. A 2011 <a href="https://za.boell.org/2015/05/18/sexualised-violence-national-debate-cross-border-observations-india-and-south-africa-0">study</a> by Tshwaranang Legal Advocacy Centre found that court proceedings got a lot of media coverage if they met a simple, grisly requirement: they should be brutal and shocking.</p>
<p>Brutality may capture people’s attention, but a lot of discussion around gender based violence in South Africa is devoid <a href="https://za.boell.org/2015/05/18/sexualised-violence-national-debate-cross-border-observations-india-and-south-africa-0">of contextual analysis</a>. </p>
<p>This comes with consequences. It normalises violence and narratives are produced in popular reporting that don’t help society identify the right interventions for dealing with violence. People come to think that the solution to gender based violence lies in greater incarceration and retributive justice, rather than interventions with society at large that produces violent men. In the absence of interventions women vent their frustrations and pain in Twitter hashtags like <a href="http://www.sundayworld.co.za/news/2017/05/13/menaretrash-karabo.-mokoenas-death-sparks-harrowing-tales-of-abuse">#menaretrash</a>. These stigmatise all men as contributing to gender based violence.</p>
<p>As I perused the newspapers, online reporting and Sunday papers after Karabo Mokoena’s death, I read the word “scourge” several times. This creates the impression that violence is visited upon us like the plagues in the Bible, without us knowing who is doing it or why. It makes the perpetrators of violence invisible. It also suggests that there’s a cure, if we just wait long enough. This type of reporting encourages short term responses but not immediate committed action and interventions.</p>
<p>When Anene Booysen’s killer applied for bail, the then-minister of Women, Youth and People with disabilities Lulu Xingwana <a href="http://www.iol.co.za/dailynews/opinion/constitution-rules-even-when-we-dont-like-it-1472648">shouted</a> “all rapists must rot in jail”. During Oscar Pistorius’ trial the governing party’s Women’s League <a href="https://www.youtube.com/watch?v=czYvrjsAqSA">echoed</a> this sentiment.</p>
<p>It is clear from these remarks that the governing African National Congress (ANC) sees higher incarceration rates as the solution to rape and femicide. Its members’ oft-repeated cry of “rot in jail” also suggests that rehabilitation is not viewed as a priority.</p>
<p>The problem is that this response individualises the challenge of violence. It focuses on individual perpetrators without attempting to understand the very complex social conditions in South Africa that contribute to men’s violent behaviour. These <a href="https://www.theguardian.com/world/2015/sep/29/south-africa-rape-nightmare-crime-stats">conditions</a> include colonial and apartheid histories of violence, endemic poverty, substance abuse, deeply held patriarchal attitudes about women’s place in society and the <a href="http://rapecrisis.org.za/rape-in-south-africa/#causes-of-rape">emasculation</a> of unemployment when men measure their worth through work, or an absence of it.</p>
<p>These issues all beg for solutions on a collective level. Without that sort of intervention, gender based violence will continue unabated.</p>
<h2>Lack of political will</h2>
<p>There is also a visible absence of political will to fight these kinds of crimes. After Anene Booysen’s murder, enraged South Africans called for a National Council on Gender Based Violence to be formed. President Jacob Zuma agreed to this and asked his then-Minister of Women, Youth and People with Disabilities to <a href="http://www.sanews.gov.za/south-africa/battle-against-gender-based-violence-everyone%E2%80%99s-business">spearhead the initiative</a>.</p>
<p>But after the country’s 2014 election the ministry was closed down. Now women’s issues are <a href="http://www.news24.com/elections/news/womens-issues-under-presidencys-watchful-eye-20140602">represented</a> by a single minister in the Presidency, and there’s no sign of the council that was promised.</p>
<p>Susan Shabangu, who is the minister for Women in the Presidency, has not demonstrated much will to genuinely tackle gender based violence. She recently described Karabo Mokoena <a href="https://mg.co.za/article/2017-05-24-karabo-mokoena-was-weak-says-minister-for-women">as weak</a>, saying this caused her death. Here we see the lack of political will to deal with sexual violence: the minister has not initiated any interventions or projects to deal with the country’s outrageous proportions of gender based violence.</p>
<h2>What needs to change</h2>
<p>South Africans are frustrated. Some express their feelings of hopelessness around violence on social media, tagging posts with #MenAreTrash. This is an example of women finding solidarity in their victimisation through telling their stories of sexual violence. These stories must be told and heard, because they show how vast the problem is and how women rarely speak out.</p>
<p>But this particular campaign also stigmatises all men as deviant. Many men may react by becoming defensive. Potential allies are alienated. Gender based violence will only diminish if men and women unite to fight against it. Men have an important role to play in this struggle. </p>
<p>Men will have to speak out to other men who are contributing to rape culture. They must start to address other men’s perceptions and stereotypes about women’s sexuality. They must call out men who believe women can be beaten to “discipline” them, or who refer to women as “sluts” when they do not like their behaviour.</p>
<p>Without intervention, the problem of sexual violence will not stop. Karabo Mokoena’s name will be joined by hundreds more on a never-ending list of loss and brutality.</p><img src="https://counter.theconversation.com/content/78352/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amanda Gouws receives funding from the NRF</span></em></p>High profile stories of femicide come with a flare up of societal outrage, protest and collective introspection. But nothing ever really changes.Amanda Gouws, Professor of Political Science, Stellenbosch UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/712862017-01-19T15:36:55Z2017-01-19T15:36:55ZHow social factors drive up suicide rates among pregnant women<figure><img src="https://images.theconversation.com/files/153211/original/image-20170118-3885-19e2yr9.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Pregnant women in South Africa who live in poor communities are more likely to consider or attempt suicide than the general population.</span> <span class="attribution"><span class="source">Mike Hutchings/Reuters</span></span></figcaption></figure><p>Pregnant women in South Africa who live in poor communities are more likely to consider or attempt suicide than the general population. That’s a <a href="http://link.springer.com/article/10.1007/s00737-016-0706-5">key finding</a> from a recent study we undertook at Hanover Park. </p>
<p>The research found 12% of pregnant women living in low-resource communities had thought of killing themselves during the previous month. In the same period, an additional 6% of pregnant women reported they had started to enact a suicide plan or attempted to end their lives. Rates of depression and anxiety were also found to be elevated among the pregnant women who took part in the study.</p>
<p>These findings mirror research about high rates of suicidal ideation and behaviour among pregnant women elsewhere in the world. A review of 17 studies in high- and low-income countries found the prevalence of suicidal ideation among pregnant and postpartum women ranged from 5% to 18%. Rates were higher among pregnant women living in <a href="http://link.springer.com/article/10.1007%2Fs00737-005-0080-1">low-income countries</a>.</p>
<p>Our study’s most-significant finding was that more than half of the pregnant women who were at risk of suicide did not have a diagnosable depressive or anxiety disorder. Their suicide risk was also associated with lower socioeconomic status, food insecurity, intimate partner violence and a lack of social support.</p>
<p>This suggests suicidal ideation among pregnant women is about more than mental illness. Past studies suggest suicide and mental illness are <a href="http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-11-57">strongly linked</a>. Pregnant women who are depressed or have problems with anxiety are more likely to experience thoughts of death and engage in suicidal behaviour compared with other pregnant women. </p>
<p>But our research shows social and economic context may be a much more important contributor to suicide risk than previously thought. </p>
<h2>Pernicious impact of adversity</h2>
<p>The findings show the pernicious impact of socioeconomic adversity, interpersonal violence and lack of social support on pregnant women’s wellbeing.</p>
<p>We found pregnant women who are the victims of intimate partner violence are twice as likely to engage in suicidal behaviour compared to other pregnant women. Those who experience food insecurity – either they go hungry regularly or they have considerable trouble feeding themselves and their families – are almost four times more likely to report suicidal behaviour.</p>
<p>Pregnant women who are not in a relationship are also more likely than other pregnant women to experience suicidal thoughts and attempt suicide. And we found suicide risk decreases as pregnant women experience more social support. </p>
<p>These findings add to the growing body of evidence showing that sociocultural and economic factors are important risk factors for suicide. Suicidal ideation and behaviour are not simply a symptom of mental illness. Suicide can be a reaction to living in a particular context or facing stressful circumstances.</p>
<p>So, our research supports the idea that suicide risk should be assessed independently of – and in addition to – depression and anxiety among pregnant women.</p>
<h2>Broader focus needed</h2>
<p>This is an important nuance. Suicide prevention initiatives have traditionally focused narrowly on identifying and treating psychiatric illness. Our findings suggest they should more broadly include interventions that tackle socioeconomic factors and adversity.</p>
<p>Interventions that focus exclusively on psychiatric determinants of suicidal behaviour are unlikely to be effective. This is especially true in low-resource settings. Contributing factors include a scarcity of mental health resources and factors that adversely affect people’s lives.</p>
<p>More work still needs to be done to identify effective suicide prevention interventions for pregnant women living in adverse conditions. This requires more collaboration between different sectors. Policymakers also need to tackle social ills and find ways to increase the level of support for pregnant women and mothers of young babies.</p><img src="https://counter.theconversation.com/content/71286/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jason Bantjes receives funding from the South African National Research Foundation and the South African Medical Research Council. </span></em></p><p class="fine-print"><em><span>Nnachebe Michael Onah receives funding from University of Waterloo and multilateral organisations. </span></em></p><p class="fine-print"><em><span>Simone Honikman receives funding from philanthropic organisations and trusts, the University of Cape Town, The Medical Research Council (SA), DFID (UK)</span></em></p><p class="fine-print"><em><span>Sally Field ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d&#39;une organisation qui pourrait tirer profit de cet article, et n&#39;a déclaré aucune autre affiliation que son poste universitaire.</span></em></p>Depression may lead pregnant women to engage in suicidal behaviour. But the socioeconomic contexts pregnant women are in may also contribute to their suicide risk.Jason Bantjes, Senior Lecturer in the Psychology Department, Stellenbosch UniversityNnachebe Michael Onah, Doctoral Candidate, University of WaterlooSally Field, Project co-ordinator: Perinatal Mental Health Project, researcher, University of Cape TownSimone Honikman, Director of the Perinatal Mental Health Project; Senior researcher, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/699862016-12-14T19:06:02Z2016-12-14T19:06:02ZAlcohol and drug use exacerbate family violence and can be dealt with<figure><img src="https://images.theconversation.com/files/148805/original/image-20161206-25760-1ygu8jj.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Alcohol and other drugs are significant risk factors for precipitating violence. </span> <span class="attribution"><span class="source">from www.shutterstock.com.au</span></span></figcaption></figure><p>Domestic violence is a widely discussed issue in Australia. However, many narratives fail to acknowledge the impact of alcohol and illicit substances on the prevalence and severity of domestic violence. They also fail to adequately describe the complexity of violence that occurs within families.</p>
<p>A <a href="http://www.ndlerf.gov.au/publications/monographs/monograph-68">new study</a> has revealed heavy episodic drinking doubles the risk of family and domestic violence.</p>
<p>This three-year study involved surveying more than 5,000 Australians and analysing police data from across the country in an effort to untangle the relationship between alcohol and other drug use, and family violence.</p>
<h2>Associations with heavy drinking</h2>
<p>Most people who have heard the stories of survivors and police won’t be surprised to hear alcohol played a significant role in the experience of violence for a proportion of the people surveyed. </p>
<p>Survey participants who reported that their partners engaged in heavy episodic drinking were nearly six times more likely to report experiencing alcohol-related intimate partner violence. Alcohol-related incidents were much more likely to involve physical violence that results in physical, psychological or emotional injury. </p>
<p>Heavy drinking was also found to be linked to increased coercive controlling behaviour. This encompasses the behaviours used to exert control over an intimate partner such as financial control, threatening and intimidating behaviour, emotional control and isolation.</p>
<p>Looking at police data, alcohol involvement in family violence incidents ranged from 23.9% in the ACT to more than half in the NT and South Australia.</p>
<p>Interestingly, more than half of the alcohol implicated in partner violence incidents was purchased between 500m and 10km of the location of the incident, with supermarkets the most frequent place of purchase.</p>
<p><a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2005.00994.x/abstract">Despite strong evidence</a> pointing to significant alcohol involvement in family violence, government responses to combat alcohol-related family violence are weak or non-existent. For example, the Commonwealth government’s <a href="https://www.dss.gov.au/women/programs-services/reducing-violence/third-action-plan">recently released plan</a> to reduce violence against women and their children failed to address the role of alcohol and drugs in its proposed strategies to reduce family violence.</p>
<h2>Illicit and licit substances</h2>
<p>Drugs are also significantly involved in family violence, with almost double the proportion of drug-related partner violence incidents resulting in a physical injury compared to drug-unrelated incidents. </p>
<p>While it is equally important to consider the role of other drugs in family violence, we need to remember that other drug use is not as prevalent in society as alcohol use. Alcohol is a legal product that is widely used, socially sanctioned and readily available.</p>
<h2>Violence is complex and diverse</h2>
<p>Our survey tried to understand the many manifestations of violence and the complex interactions between people in families and intimate relationships. </p>
<p>Women, men and children are all victims and offenders, and some relationships are far more complex than simply labelling an individual “perpetrator” or “victim”. <a href="http://www.sciencedirect.com/science/article/pii/S1359178915000828">Longitudinal studies</a> – those that follow people over time – show growing up experiencing violence or neglect predicts future involvement in family violence.</p>
<p>In our study, we used the idea of “coercive controlling behaviour” to understand different behaviours within relationships. Around half of respondents had a partner who engaged in high levels of coercive controlling behaviour toward them, and 66.8% themselves engaged in high levels of coercive controlling behaviour toward their partner. </p>
<p>The three most frequent coercive controlling behaviours respondents and partners engaged in were “provokes arguments”, “shouts or swears”, and “is jealous or possessive”.</p>
<p>Alcohol was also a factor in incidence of coercive controlling behaviour. In our survey, 56.3% of respondents who engaged in high levels of coercive controlling behaviour reporting drinking at hazardous levels.</p>
<h2>What can we do?</h2>
<p>There are a lot of evidence-based strategies out there that are not being used, but if employed could result in immediate and tangible reductions in family-violence harm. As the report indicates, the majority of alcohol consumed during a family violence incident is purchased close to home. So we need to consider reducing the availability of alcohol. </p>
<p>This can be achieved through imposing caps on the number of takeaway liquor licences and restricting the strength of alcohol available for sale within communities, particularly those identified as already having high levels of violence.</p>
<p>Increasing the price of alcohol through a minimum unit price or increased taxation have <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2011.03763.x/abstract">repeatedly</a> been found to be <a href="http://pubs.niaaa.nih.gov/publications/arh26-1/22-34.htm">effective</a>.</p>
<p>There is also a need to combine the expertise of alcohol and drug and family violence agencies. With such a significant overlap between the two agencies, it’s vital they collaborate and provide services sensitive to complex needs. This includes rehabilitation programs that deal with family issues, alcohol and drug, and <a href="http://www.journalofsubstanceabusetreatment.com/article/S0740-5472(99)00098-7/abstract">other relevant issues concurrently</a>.</p>
<p>To prevent recidivism, there should be mandatory sobriety or treatment orders attached to relevant family violence sentences. <a href="http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.300989?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%3Dpubmed">This has proven successful</a> in parts of the US where these types of programs exist. The program involves offenders of alcohol-related crimes, including family violence, undergoing regular sobriety testing, with a short prison sentence imposed on those who fail the test.</p>
<p>Australia has come a long way in responding to family and domestic violence in the past decade. <a href="http://jiv.sagepub.com/content/31/10/1842.abstract">Reliable evidence</a> from <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2011.03763.x/abstract">around the world</a> <a href="http://www.jsad.com/doi/abs/10.15288/jsad.2015.76.628">shows us</a> time and again responding to some of the key factors driving violence such as alcohol, drugs and mental health can have rapid results and reduce the burden of this awful and complex problem. It can also save money for the community; money that could be spent on more support services.</p><img src="https://counter.theconversation.com/content/69986/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Queensland government and Australian Drug Foundation, travel and related costs from Australasian Drug Strategy Conference. He is affiliated with academic journal Addiction. He has acted as a paid expert witness on behalf of a licensed venue and a security firm.</span></em></p><p class="fine-print"><em><span>Richelle Mayshak ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d&#39;une organisation qui pourrait tirer profit de cet article, et n&#39;a déclaré aucune autre affiliation que son poste universitaire.</span></em></p>A new study has revealed heavy episodic drinking doubles the risk of family and domestic violence.Peter Miller, Professor of Violence Prevention and Addiction Studies, Deakin UniversityRichelle Mayshak, Associate Lecturer, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/692142016-11-28T05:40:49Z2016-11-28T05:40:49ZFactCheck Q&A: what are the facts on funding for domestic violence legal services in Australia?<figure><img src="https://images.theconversation.com/files/147507/original/image-20161125-15368-chvyms.JPG?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Writer and actor Nakkiah Lui, speaking on Q&amp;A. </span> <span class="attribution"><span class="source">Q&amp;A</span></span></figcaption></figure><p><strong>The Conversation is fact-checking claims made on Q&amp;A, broadcast Mondays on the ABC at 9.35pm. Thank you to everyone who sent us quotes for checking via <a href="http://www.twitter.com/conversationEDU">Twitter</a> using hashtags #FactCheck and #QandA, on <a href="http://www.facebook.com/conversationEDU">Facebook</a> or by <a href="mailto:checkit@theconversation.edu.au">email</a>.</strong></p>
<hr>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/fXWqvcC2ugg?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen></iframe>
<figcaption><span class="caption">Excerpt from Q&amp;A, November 21, 2016. Watch from 5.10.</span></figcaption>
</figure>
<blockquote>
<p>… I think cuts to frontline legal services for victims of domestic violence … I think there was $35 million was cut from the Coalition to frontline legal services – that doesn’t help. <strong>– Writer and actor Nakkiah Lui, <a href="http://www.abc.net.au/tv/qanda/txt/s4559268.htm">speaking on Q&amp;A</a>, November 21, 2016.</strong></p>
</blockquote>
<p>In response to a question regarding violence against women and children, Q&amp;A panellist Nakkiah Lui said that a A$35 million cut to frontline legal services “doesn’t help.” </p>
<p>Is it true the Coalition government cut $35 million to frontline legal services for victims of domestic violence?</p>
<h2>Checking the source</h2>
<p>When asked for sources to support her statement, Nakkiah Lui referred The Conversation to an October 2016 news <a href="https://www.theguardian.com/society/2016/oct/28/coalition-to-unveil-carve-up-of-30m-in-domestic-violence-legal-assistance">report</a> by The Guardian, which said: </p>
<blockquote>
<p>These cuts include $35m from Community Legal Centres, which provide frontline support services to domestic violence victims.</p>
</blockquote>
<p>She also cited two <a href="https://communitylawblog.wordpress.com/2016/06/16/prime-minister-its-time-to-acknowledge-and-act-on-the-crisis-in-community-legal-centre-funding/">Community Law Blog</a> <a href="https://communitylawblog.wordpress.com/2016/06/23/legal-peak-rejects-brandis-comments-urges-pm-response-to-open-letter-on-legal-help-crisis/">articles</a> from June 2016. Lui said that:</p>
<blockquote>
<p>The <a href="http://www.communitylaw.org.au/">Federation of Community Legal Centres</a> has addressed the funding cuts with passion and integrity - I hope they are listened to and supported as they are very much needed.</p>
</blockquote>
<p>You can read her full response <a href="http://theconversation.com/full-response-from-nakkiah-lui-69412">here</a>.</p>
<h2>What are Community Legal Centres?</h2>
<p>In Australia, frontline legal services for people who are disadvantaged are delivered by <a href="http://www.pc.gov.au/inquiries/completed/access-justice/report/access-justice-overview.pdf">a mix of</a> <a href="http://www.naclc.org.au/resources/NACLC%20Census%20-%20National%20Report%202015%20-%20FINAL.pdf">Community Legal Centres</a>, <a href="http://www.australia.gov.au/content/legal-aid">Legal Aid Commissions</a>, <a href="http://www.familyrelationships.gov.au/searchpages/GeneralService.aspx?ResourceId=3848">Family Violence Prevention Legal Services</a> and <a href="http://www.natsils.org.au/">National Aboriginal and Torres Strait Islander Legal Services</a> (NATSILS).</p>
<p>Community Legal Centres are not-for-profit organisations. Some services offered by Legal Aid Commissions are free. Both of these organisations receive Commonwealth funding under the <a href="https://www.ag.gov.au/LegalSystem/Legalaidprogrammes/Pages/National-Partnership-Agreement-on-Legal-Assistance-Services.aspx">National Partnership Agreement on Legal Assistance Services</a>, which runs from 2015 to mid-2020.</p>
<p>For Community Legal Centres and Legal Aid Commissions, services for people experiencing domestic and family violence are in extremely high demand. </p>
<h2>Is it true $35 million has been cut?</h2>
<p>It hasn’t been cut <em>yet</em>. But a $35 million cut in federal funding (spread over three years) is on the way.</p>
<p>Under the <a href="https://www.ag.gov.au/LegalSystem/Legalaidprogrammes/Pages/National-Partnership-Agreement-on-Legal-Assistance-Services.aspx">National Partnership Agreement on Legal Assistance Services</a> (the agreement under which Community Legal Centres are funded) the federal government plans to reduce future funding for Community Legal Centres over three years. Compared with 2016-17 levels of $42.2 million, Community Legal Centre funding will be reduced by:</p>
<ul>
<li>$12.1 million in 2017-2018</li>
<li>$11.6 million in 2018-2019</li>
<li>$11.2 million in 2019-2020</li>
</ul>
<p>That adds up to <a href="http://www.communitylawaustralia.org.au/wp-content/uploads/2016/03/NACLC_Federal_Budget_Sub_2016_17_Final_PDF.pdf">$34.9 million over three years</a>. The cuts will be shared across more than 160 Community Legal Centres across Australia. So, compared to 2016-17 levels, Community Legal Centres are set to lose about $35 million in funding between 2017 and 2020.</p>
<p>So Nakkiah Lui’s statement is correct. But her quote doesn’t quite tell the whole story. </p>
<h2>Additional funding for Legal Aid and other services</h2>
<p>The federal government has announced other funding for Community Legal Centres and other services that support victims of family and domestic violence.</p>
<p>Under the same <a href="https://www.ag.gov.au/LegalSystem/Legalaidprogrammes/Documents/NationalPartnershipAgreementOnLegalServices.PDF">National Partnership Agreement on Legal Services</a> that would result in the $35 million cut, the federal government promised a $12 million increase in funding for Legal Aid Commissions between 2015 and 2020.</p>
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<p>In September 2015, the federal government <a href="http://www.malcolmturnbull.com.au/media/release-womens-safety-package-to-stoptheviolence">announced</a> $100 million in funding for women and children at high risk of experiencing violence. The announcement was part of the <a href="https://www.dss.gov.au/women-programs-services-reducing-violence/womens-safety-package">Women’s Safety Package</a>. </p>
<p>In this package, $15 million was committed over three years to establish <a href="https://www.attorneygeneral.gov.au/Mediareleases/Pages/2015/FourthQuarter/16-October-2015-Womens-Safety-Package-Legal-Support-Providers.aspx">12 new specialist domestic violence units</a> within a number of legal assistance providers.</p>
<p>These specialist domestic violence units will be set up by Legal Aid Commissions and Community Legal Centres across the country. In addition to legal assistance, they will offer practical help, such as access to counselling and crisis accommodation.</p>
<p>In October 2016, the federal government announced its <a href="https://www.attorneygeneral.gov.au/Mediareleases/Pages/2016/FourthQuarter/Third-action-plan-to-reduce-family-violence.aspx">Third Action Plan</a> to reduce family violence. The funding package includes $30 million for “frontline legal assistance and family law services” over three years and provides: </p>
<ul>
<li>$5 million to 11 Community Legal Centres and two Legal Aid Commissions that received funding under the Women’s Safety Package, to extend that funding for one year until 2019</li>
<li>$18.5 million to Legal Aid Commissions for integrated duty lawyer and social support services in family law courts</li>
<li>$6.2 million for Family Relationship Centres to pilot family dispute resolution for vulnerable families, particularly Indigenous and culturally and linguistically diverse families, and</li>
<li>$300,000 to the Attorney-General’s department for data analysis across the sector to enhance understanding of domestic, family and sexual violence.</li>
</ul>
<p>Overall, there have been <a href="http://www.natsils.org.au/portals/natsils/MEDIA%20RELEASE%20-%20pre-budget%20-%20020516.pdf?ver=2016-05-02-163434-117">decreases in funding</a> for the Aboriginal and Torres Strait Islander Legal Service (ATSILS) too. But in October 2016, the Coalition announced a further <a href="http://www.nigelscullion.com/media+hub/Additional+%2425+million+to+tackle+family+violence+in+Indigenous+communities">$25 million</a> to: </p>
<blockquote>
<p>help frontline services to intervene early to prevent violence from occurring, while also addressing the drivers of violence in Indigenous communities. </p>
</blockquote>
<p>But it’s not clear if any of this <a href="http://www.natsils.org.au/portals/natsils/MEDIA%20RELEASE%20-%20NATSILS%20responds%20to%20Coalition%20FV%20funding%20-%20210616.pdf?ver=2016-06-21-141555-740">funding</a> will go to ATSILS.</p>
<p>The funded activities under this package will include therapeutic services, perpetrator rehabilitation programs, family case-management and legal services. </p>
<h2>Are legal services being adequately funded?</h2>
<p>The Productivity Commission <a href="http://www.pc.gov.au/inquiries/completed/access-justice/report">recommended in 2014</a> that an extra $200 million a year was needed to ensure proper provision of legal services to disadvantaged people. It recommended $120 million of this increase should be <a href="http://www.theage.com.au/federal-politics/political-news/australian-legal-aid-services-need-200-million-more-a-year--productivity-commission-20141203-11zff7.html">provided by the federal government</a>. </p>
<p>Overall, federal funding to date has fallen far short of the Productivity Commission’s recommendation. </p>
<p>One of the aims of the <a href="https://www.dss.gov.au/women/programs-services/reducing-violence/the-national-plan-to-reduce-violence-against-women-and-their-children-2010-2022">National Plan to Reduce Violence against Women and their Children</a> is to improve access to justice for women and children. </p>
<p>As <a href="http://www.rcfv.com.au/Report-Recommendations">recognition and reporting</a> of domestic and family violence increases, the demand for legal services by victims (and perpetrators) is likely to increase.</p>
<p>People experiencing or escaping domestic and family violence <a href="http://www.alrc.gov.au/sites/default/files/pdfs/publications/04.%20Purposes%20of%20Laws%20Relevant%20to%20Family%20Violence.pdf">require</a> <a href="https://www.communities.qld.gov.au/resources/gateway/campaigns/end-violence/about/special-taskforce/dfv-report-vol-one.pdf">integrated legal help</a> in relation to protection orders, <a href="https://aifs.gov.au/publications/evaluation-2012-family-violence-amendments">family law</a>, <a href="https://www.ag.gov.au/FamiliesAndMarriage/FamilyLawCouncil/Documents/Family-with-Complex-Needs-Intersection-of-Family-Law-and-Child-Protection-Systems-Final-Report-Terms-3-4-5.PDF">child protection</a> and criminal matters, especially <a href="http://dfvbenchbook.aija.org.au/sentencing/sentencing-considerations-breaches-of-protection-orders/">breaches of protection orders</a>. </p>
<p>People fleeing domestic and family violence also regularly seek legal services for <a href="http://www.aihw.gov.au/homelessness/domestic-violence-and-homelessness/">housing</a>, credit and debt challenges and access to social security.</p>
<h2>Verdict</h2>
<p>Nakkiah Lui was right – Community Legal Centres are set to lose about $35 million in federal funding between 2017 and 2020.</p>
<p>But her quote doesn’t tell the whole story (which is often the case on a fast-paced live television show). Other additional funding has been promised for Community Legal Centres, Legal Aid Commissions and other services that support victims of family and domestic violence. </p>
<p>Overall, federal funding to date for legal services for disadvantaged people has fallen far short of the Productivity Commission’s recommendations. <strong>– Heather Douglas.</strong></p>
<hr>
<h2>Review</h2>
<p>This is a sound analysis of the federal funding that has been cut (and promised) to family violence legal services. The author is correct to note that Nakkiah Lui was right to say that the federal government has announced cuts of $35 million for Community Legal Centres. However, as this analysis rightly reveals, there are multiple funding announcements that need to be taken into consideration when assessing federal funding levels.</p>
<p>The author rightly notes that, regardless of current and promised funding, there is an ongoing unmet need. <strong>– Kate Fitz-Gibbon</strong></p>
<hr>
<p><div class="callout"> Have you ever seen a “fact” worth checking? The Conversation’s FactCheck asks academic experts to test claims and see how true they are. We then ask a second academic to review an anonymous copy of the article. You can request a check at checkit@theconversation.edu.au. Please include the statement you would like us to check, the date it was made, and a link if possible.</div></p><img src="https://counter.theconversation.com/content/69214/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Douglas receives funding from the Australian Research Council (Future Fellowship FT140100796) and the Australasian Institute of Judicial Administration (AIJA). She is affiliated with DVConnect. </span></em></p><p class="fine-print"><em><span>Kate Fitz-Gibbon is a Senior Lecturer in Criminology at Monash University and a Honorary Research Fellow in the School of Law and Social Justice at University of Liverpool. She is a member of the Monash Gender and Family Violence Research Focus Program.</span></em></p>Has the Coalition government cut $35 million from frontline legal services for victims of domestic and family violence?Heather Douglas, Professor of Law, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/677722016-10-31T19:03:56Z2016-10-31T19:03:56ZStudy confirms intimate partner violence leading health risk factor for women<figure><img src="https://images.theconversation.com/files/143837/original/image-20161031-15783-1ha4f2m.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">For women of reproductive age and Indigenous women, intimate partner violence is the single biggest health risk factor. </span> <span class="attribution"><span class="source">from www.shutterstock.com.au</span></span></figcaption></figure><p>Barely a week passes without a media report of the suffering or tragic death of a woman at the hands of a partner. Typically, these accounts focus on the individuals involved. While important, in isolation, such a focus can belie the fact intimate partner violence is a wider social problem, obscuring both the factors contributing to it and opportunities to prevent it.</p>
<p>A <a href="http://anrows.org.au/publications/compass/preventable-burden-measuring-and-addressing-the-prevalence-and-health-impacts">study being launched today</a> by Australia’s National Research Organisation for Women’s Safety confirms the serious impacts of intimate partner violence. The analysis, undertaken by the Australian Institute of Health and Welfare, provides estimates of the impact of intimate partner violence on women’s health.</p>
<p>Data from the Personal Safety Survey, Australia’s most reliable violence prevalence survey, was used as a key input.</p>
<p>Since the age of 15, one in four women in Australia have experienced <a href="http://anrows.org.au/research-program/research-program-2014-16/PSS">at least one incident of violence by a partner</a>. This includes violence perpetrated by a live-in partner as well as boyfriends, girlfriends or dates. This is based on a definition of violence, used by the Personal Safety Survey, which includes physical and sexual assault, as well as face-to-face threats the victim believed <a href="http://www.abs.gov.au/AUSSTATS/abs@.nsf/Latestproducts/4906.0Glossary12012?opendocument&amp;tabname=Notes&amp;prodno=4906.0&amp;issue=2012&amp;num=&amp;view=">were likely and able to be carried out</a>. </p>
<p>When emotional abuse by a live-in partner is included, (defined as controlling behaviours aimed at causing fear or emotional harm), it is estimated one in three women have experienced <a href="http://anrows.org.au/publications/compass/preventable-burden-measuring-and-addressing-the-prevalence-and-health-impacts">violence or abuse by an intimate partner</a>.</p>
<h2>Serious impacts on women’s health</h2>
<p>Drawing on Australian and international studies, the Australian Institute of Health and Welfare found an association between women <a href="http://anrows.org.au/publications/landscapes/health-outcomes-intimate-partner-violence-against-women">experiencing partner violence and a wide range of health impacts</a>. Particularly compelling evidence was found linking partner violence to:</p>
<ul>
<li><p>anxiety </p></li>
<li><p>depression</p></li>
<li><p>suicide and self-inflicted injuries</p></li>
<li><p>alcohol use disorders</p></li>
<li><p>homicide and violence</p></li>
<li><p>early pregnancy loss.</p></li>
</ul>
<p>These factors were used in calculating the burden of disease of partner violence.</p>
<p>The burden of disease is a calculation of the impact of particular diseases and risk factors on an entire population. It is a measure of both fatal and non-fatal health impacts, which take into account the severity and duration of health conditions.</p>
<p>The study found partner violence was among the top ten risk factors contributing to disease burden among all adult women, regardless of whether partner violence was defined broadly (violence by both live-in and non-live-in partners, and emotional abuse by live-in partners) or narrowly (only physical and sexual violence in live-in relationships).</p>
<p>Among women 18 to 44 years, it was the biggest single risk factor when violence in all intimate relationships was included, bigger than smoking, alcohol use or being overweight or obese. When considering only violence by live-in partners, in this age group, partner violence ranked second only to alcohol use. </p>
<p>The study found there had been no change in the burden since 2003.</p>
<h2>Burden even larger for Indigenous women</h2>
<p>Physical and sexual partner violence is the leading risk factor contributing to disease burden in Indigenous women aged 18 to 44 years. The rates of burden of physical and sexual violence in both cohabiting and non-cohabiting relationships were compared between Indigenous and non-Indigenous women. Rates for Indigenous women were:</p>
<ul>
<li>6.3 times greater among women 18-44 years; and</li>
<li>5.3 times greater among women of all ages. </li>
</ul>
<p>This burden was the leading contributor to the gap in burden between Indigenous and non-Indigenous women aged 18 to 44; and the sixth largest contributor to the gap among women of all ages.</p>
<h2>A preventable burden</h2>
<p>Front-line services, such as the police, women’s refuges and counselling and support services play a vital role, reducing exposure to violence and its health consequences by helping women to secure safety, supporting their recovery, and holding men who use violence accountable. Recent inquiries in <a href="http://www.rcfv.com.au/">Victoria</a> and <a href="https://www.qld.gov.au/community/documents/getting-support-health-social-issue/dfv-report-vol-one.pdf">Queensland</a> show that although such services have improved, much more needs to be done. </p>
<p>Another effective way to reduce the burden is to prevent “new cases” of partner violence, by tackling its underlying causes. These are increasingly well understood, <a href="https://www.ourwatch.org.au/getmedia/d53470da-fe17-4af1-baca-bedfd7f9b235/Change-the-story-framework-foundations-1-updated.pdf.aspx">along with the means to address them</a>.</p>
<p>Among these factors is inequality between men and women, an influence made particularly potent when coupled with poverty, social exclusion and <a href="http://www.ourwatch.org.au/What-We-Do/National-Primary-Prevention-Framework">other forms of discrimination</a>. </p>
<p>A sustained, coordinated approach is needed which extends beyond affected individuals, and engages a wide range of sectors – not just front-line services - to shift social, community and organisational norms, practices and policies known to increase the likelihood of violence. A similar approach, often referred to as a public health approach, has been used very successfully in Australia to tackle other prevalent risk factors such as tobacco use and road safety hazards.</p>
<hr>
<p><em>Dr Peta Cox, Senior Research Officer for ANROWS co-authored this article. Dr Cox will participate on the expert panel at the launch of the study on 1 November 2016.</em></p><img src="https://counter.theconversation.com/content/67772/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kim Webster works for ANROWS, a not-for-profit that receives funding from Commonwealth and state governments.</span></em></p><p class="fine-print"><em><span>Zuleyka Zevallos works for ANROWS, a not-for-profit that receives funding from Commonwealth and state governments. </span></em></p>A study being launched today by Australia’s National Research Organisation for Women’s Safety confirms the serious impacts of intimate partner violence.Kim Webster, PhD candidate, University of MelbourneZuleyka Zevallos, Adjunct Research Fellow, Sociology, Swinburne University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/638022016-10-18T01:37:27Z2016-10-18T01:37:27ZHow sexual partner abuse has changed with social media<figure><img src="https://images.theconversation.com/files/141675/original/image-20161013-3950-1eprvgu.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">An old problem with a digital twist.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-144586100">www.shutterstock.com</a></span></figcaption></figure><p>Incidents involving threats to expose sexual images, or what media are calling “sextortion,” are not new, but have evolved with social media.</p>
<p>In a <a href="http://www.unh.edu/ccrc/Sextortion%20Report%20final%206-22-2016.pdf">large study</a> we recently did on the topic, we found that sextortion mostly involves the classic dynamics of abusive relationships, or malicious online seducers with a few digital-age twists. The dynamics are offensive and manipulative, to be sure, but also sadly familiar. We have seen similar dynamics in our research about <a href="http://www.unh.edu/ccrc/pdf/CV231_Sexting%20Typology%20Bulletin_4-6-11_revised.pdf">sexting</a> and other internet-related <a href="http://www.unh.edu/ccrc/internet-crimes/papers.html">sex crimes</a>.</p>
<p>We have gotten better as a society over the last generation in providing services to victims of intimate partner abuse and sexual assault, as evidenced by rape crisis centers and specialized police and prosecution units. But reports of sextortion show the distance we still have to go in raising public awareness. The varieties and dynamics of all forms of sexual exploitation and intimate abuse are important for the public and policymakers to understand so we can craft prevention strategies to help victims.</p>
<h2>Distress for young victims</h2>
<p>In our study, we asked young people between the ages of 18 and 25 to complete an online survey telling us their stories about sextortion, in partnership with the nonprofit <a href="https://www.wearethorn.org/sextortion/">Thorn</a> and through ads on Facebook. We defined sextortion as threats to expose sexual images in order to make a person do something or for other reasons, such as revenge or humiliation.</p>
<p>Among the 1,631 respondents to the online survey, many gave harrowing accounts about threats to send sexual images to parents, employers and classmates. About half of the victims were youth under age 18. In many cases, these images were originally entrusted willingly to intimate partners. In other cases, they were coerced or even fabricated. The perpetrators were mostly men targeting women and girls, but we also heard about sextortion within LGBTQ relationships.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/141676/original/image-20161013-3982-12bsfdd.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip">
<figcaption>
<span class="caption">Perpetrators target victims to humiliate them.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-258726044.html">www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>The cases could be largely divided into two dynamic groups. On the one hand were spurned or rejected boyfriends who in their bitterness or desperation used threats to punish former lovers, or coerce them back into relationships. These men stalked, harassed and badgered their former partners in ways that could be terrifying and overwhelming.</p>
<p>The other group, the malicious seducers, used friendship, deception and promises of romance to acquire compromising pictures from targets they met online, and then used these pictures to extract more images and sex. They tracked down victims’ contacts on social media sites, stalked victims online and used threats to force them into demeaning webcam sex.</p>
<p>The threats alone were highly distressing, but even more alarming, perpetrators actually carried out their threats to distribute intimate images in almost half of cases. The personal and psychological toll on victims was intense, with almost one-quarter seeking medical or mental health assistance and 12 percent moving from their homes as a result. </p>
<h2>Challenges to getting help</h2>
<p>Like other victims of intimate abuse and <a href="http://www.sciencedirect.com/science/article/pii/S014067360860522X">sexual assault</a>, victims of sextortion reported pervasive feelings of shame, embarrassment and self-blame. These feelings often kept them from seeking help from friends and family, or from reporting to technology companies that ran websites or apps used for sextortion. </p>
<p>Unfortunately, when they did reach out, it was often to no avail. Forty percent of those who had the courage to report to websites or apps said that the responses that they received were not helpful.</p>
<p>One victim said: </p>
<blockquote>
<p>“It was a very difficult and long process, which involved proving my identity and explaining what had happened via email to the owner of the website who was very unwilling to have the image taken down… The website initially took down the photo, but then allowed [the perpetrator] to repost it less than a week later.”</p>
</blockquote>
<p>In many cases, technology companies refused to remove images posted by perpetrators and did not intervene when their platforms were used to stalk and harass. Companies may not have enough staff to deal with the complaints or are averse to being seen as censors. </p>
<p>Few victims reported sextortion to law enforcement. When they did, police assistance was also meager. Victims described a lack of criminal laws addressing sextortion and being shamed or blamed by police. Some victims who were minors were threatened with prosecution under child pornography laws. </p>
<p>There are few laws specifically about these dynamics. Some states have developed laws to deal with sextortion but mostly, if they are prosecuted at all, it is under statutes related to stalking, hacking, general extortion or child pornography. One problem with child pornography statutes is that in theory they can criminalize the behavior of the victim who made and transmitted the image in the first place.</p>
<h2>Responsibility in tech</h2>
<p>Reducing the sense of stigma and self-blame among victims is an important step to foiling perpetrators.</p>
<p>We believe there is a special role here for the technology industry which has built their business model on inviting young people into their spaces to share the intimate details and deeply fraught aspects of their relationships. The industry has a responsibility to protect and respond to their young customers when their platforms are used for abuse. </p>
<p>We know that prevention has many advantages over repair, and the companies with their huge youth client base are well positioned to influence norms of behavior. We also know that most victims of sexual offenses and intimate abuse do not report to law enforcement, so the help available online may be the only help that large numbers of victims ever get. </p>
<p>New technology does afford some opportunities for new ways to get help. The same creative imaginations that have made sextortion so easy can surely find some equally creative and effective ways to prevent it and assist those who have been harmed.</p><img src="https://counter.theconversation.com/content/63802/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Finkelhor receives funding from US Department of Justice and Thorn. </span></em></p><p class="fine-print"><em><span>Janis Wolak receives funding from the US Department of Justice and Thorn. </span></em></p>Threats to humiliate an intimate partner by sharing explicit photos or video is an old problem with a new digital twist, a new study finds.David Finkelhor, Professor of Sociology, University of New HampshireJanis Wolak, Senior Researcher, University of New HampshireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/514942015-12-01T15:13:31Z2015-12-01T15:13:31ZHIV can be prevented in babies if their mothers are kept safe<figure><img src="https://images.theconversation.com/files/103881/original/image-20151201-26591-97wh5h.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Stigma and intimate partner violence prevent HIV-positive mothers from accessing care and treatment. </span> <span class="attribution"><span class="source">Reuters/Darrin Zammit Lupi </span></span></figcaption></figure><p>When pregnant HIV-positive women regularly take their medication, mother-to-child transmission of HIV can be virtually <a href="http://www.who.int/hiv/pub/mtct/PMTCTfactsheet/en/">eliminated</a>. Women on anti-retroviral therapy also have better medical outcomes, boosting the potential that they and their children and will lead healthy lives.</p>
<p>Yet, in South Africa, <a href="http://www.aidsmap.com/Maternal-deaths-due-to-HIV-not-declining-despite-PMTCT-successes-in-South-Africa/page/2833384/">maternal deaths</a> related to HIV have stayed consistently high since 2007. This is mainly because mothers aren’t on the anti-retroviral treatment they need.</p>
<p>Only half of HIV-positive mothers are in medical care by the time their baby is six months old. While the data is consistent across reports from <a href="http://www.aidsmap.com/Low-rates-of-engagement-with-HIV-care-among-women-who-have-recently-given-birth-in-Cape-Town-townships/page/2992319">Cape Town</a>, <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600093/">Johannesburg</a> and <a href="http://www.biomedcentral.com/1471-2431/12/146">Durban</a>, maternal retention may be worse in rural areas of the country where clinics are harder to reach.</p>
<p>This means that despite fanfare around South Africa’s <a href="http://www.aidsmap.com/South-African-clinics-already-achieving-zero-new-HIV-infections-in-children/page/2632383/">headway</a> towards eliminating HIV transmission to babies, much more needs to be done.</p>
<h2>A high drop out rate</h2>
<p>The global focus over the past decade has been to distribute HIV medicines and make sure that clinics are staffed to test women for HIV during pregnancy. But much less is known about why individual women are unable to take up medicine or adhere to treatment during their pregnancy.</p>
<p>Studies across the continent suggest that partners play a role in how HIV-positive mothers access care and treatment. One aspect that may greatly hinder women’s access to HIV care and treatment is intimate partner violence.</p>
<p>In a recent systematic <a href="http://sciencenow.unaids.org/post/15-million-accessing-treatment-137">review</a>, our team found that women reporting partner violence are half as likely to adhere to treatment. These women also have 36% lower odds of achieving viral suppression.</p>
<p>But none of the studies included in the review examine partner violence in pregnancy. Our team hopes to address this research gap by speaking to roughly 1 500 pregnant women at antenatal clinics in inner-city Johannesburg.</p>
<h2>Links between partner violence and HIV</h2>
<p>By speaking to women who are pregnant or bringing their six-week old babies for immunisation visits, we hope to learn how the experience of recent partner violence – physical or sexual assault within the past 12 months – alters women’s ability to adhere to HIV drugs.</p>
<p>We’re also conducting in-depth interviews with HIV-positive women who report violence around the time of pregnancy. These interviews highlight a complex set of issues related to hiding medication, strategically avoiding partner disclosure and being too depressed to worry about adherence.</p>
<p>Several pregnant women reported a violent or severe reaction when a partner learned of their HIV diagnosis, but this was certainly not the norm. One woman skipped out on HIV medication altogether because she knew that it would be impossible to safely take it while living with her violent husband.</p>
<p>An overarching counter-narrative has been that mothers are keenly aware of their baby’s health, and will make great sacrifices to make sure they do not transmit HIV to their baby. For many women, this theme of “active motherhood” overcomes other barriers to retention and adherence that they might face.</p>
<p>What’s less clear is how these women will adhere to HIV medication later in their infant’s life, especially since global <a href="http://www.aidsmap.com/Global-evidence-of-lower-adherence-to-ARVs-after-giving-birth/page/2521871/">evidence</a> shows adherence decreases steadily after birth.</p>
<p>In a context where their own lives are not safe due to threat of violence from a male partner, how can new mothers balance the needs of an infant and keep up with chronic HIV medication?</p>
<p>Home visiting programmes were helpful for HIV-positive mothers in Cape Town, but researchers <a href="http://www.sciencedirect.com/science/article/pii/S0749379715002251">found</a> that the persistent effects of partner violence and depression washed out intervention effects. In the future, health workers should be trained to address intersecting challenges in women’s lives, like violence and mental health.</p>
<h2>Addressing partner violence</h2>
<p>So how, exactly, can health workers ensure that women’s experience of partner violence is reduced?</p>
<p>Global evidence around this question is mixed. Data from several <a href="http://archinte.jamanetwork.com/article.aspx?articleid=409520">studies</a> suggests that women want to be asked by health workers about partner violence. But only about half of health programmes that were tested <a href="http://www.sciencedirect.com/science/article/pii/S0749379713005515">demonstrate</a> a measurable decline in partner violence.</p>
<p>One approach is to draw on <a href="http://www.cehat.org/go/uploads/Publications/A%20319%20The%20health-systems%20response%20to%20violence%20against%20women.pdf">best-practice</a> elements from programmes that have worked in the past. This includes training health providers and pairing clinic-based sessions with further referrals. Another idea is to create interventions underpinned by therapeutic skills like empathy, containment, and client-centered sessions. It is also essential to deliver brief, individual sessions within a busy clinic setting.</p>
<p>Our team is testing this model called “Safe &amp; Sound” using antenatal nurses in urban Johannesburg. If successful, it will see reductions in violence and improvements to mental health. Both elements are crucial for women’s wellbeing and their uptake of HIV treatment.</p>
<p>This approach aligns with the direction of the HIV field. The latest HIV <a href="http://link.springer.com/article/10.1007/s11904-014-0252-6">research</a> says that health providers should support HIV-positive mothers to face barriers to care, such as stigma and partner dynamics.</p>
<p>If a brief health intervention could jointly improve HIV and violence outcomes, it could have a major impact on the lives of women and children across the continent.</p><img src="https://counter.theconversation.com/content/51494/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Abigail M Hatcher works for the Wits Reproductive Health &amp; HIV Institute. She receives funding from the World Health Organization and the What Works to Prevent Violence consortium.</span></em></p>For pregnant HIV-positive women taking anti-retrovirals is critical for their babies' health. Intimate partner violence affects adherence, and must be addressed as part of women's HIV treatment.Abigail M Hatcher, Senior Researcher, University of the WitwatersrandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/502382015-11-11T19:22:46Z2015-11-11T19:22:46ZBeyond gender: LGBTIQ abuse shows it’s time to shift the debate on partner violence<figure><img src="https://images.theconversation.com/files/101540/original/image-20151111-21223-5lz156.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Violence plays out in highly gendered ways. But many more factors are at play.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-256410937/stock-photo-people-homosexuality-same-sex-marriage-gay-and-love-concept-close-up-of-happy-lesbian-couple.html?src=ZYUQeDKlZPzprGjhOMN2Bw-3-88">Syda Productions/Shutterstock</a></span></figcaption></figure><p>A <a href="http://www.theguardian.com/society/2015/nov/03/domestic-violence-affects-lgbtiq-communities-at-alarming-levels-report?CMP=soc_568">recently released report</a> confirms what a growing body of national and international research has shown: lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people experience family and sexual violence at rates similar to, or higher than, heterosexual women.</p>
<p>Despite this, discussions about sexual and family violence continue to be both gendered and heterosexual – as something that men do to women. Our <a href="https://www.dss.gov.au/our-responsibilities/women/programs-services/reducing-violence/the-national-plan-to-reduce-violence-against-women-and-their-children-2010-2022">national policy</a> for addressing sexual and family violence frames the problem largely in these terms. </p>
<p>Yet, research suggests other factors are also at play here. It’s time to re-think the centrality of gender-based power relationships in our understanding of sexual and family violence.</p>
<h2>LGBTIQ family and sexual violence</h2>
<p>The small but robust body of work on sexual and family violence against LGBTIQ people paints a concerning picture – although it should be noted that Australian data relating to intersex and queer communities is limited. </p>
<p>In the aforementioned report, more than half of the New South Wales-based LGBTIQ participants had experienced emotional abuse. A further third had experienced sexual or physical abuse in their relationships. </p>
<p>These findings echo previous <a href="http://www.glhv.org.au/files/ComingForwardReport.pdf">Victorian research</a> and <a href="https://www3.aifs.gov.au/acssa/pubs/sheets/rs3/index.html">other studies</a> which indicate that rates of violence in same-sex relationships are similar to those in opposite-sex relationships. </p>
<p>Rates of <a href="http://www.aic.gov.au/publications/current%20series/tandi/461-480/tandi469.html">intimate partner homicide</a> are comparable in opposite-sex and same-sex relationships. </p>
<p>In Australia, an estimated one in five women and one in 20 men experienced <a href="https://www3.aifs.gov.au/acssa/pubs/sheets/rs5/index.html#ap4">sexual violence</a> or <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4906.0Chapter7002012">intimate partner violence</a> in their lifetime. Women and men who identify as homosexual or bisexual <a href="http://dx.doi.org/10.1071/SH14103">have experienced</a> two to four times those rates. While sexual violence is often a form of family violence, it does not always occur within a family violence context. </p>
<p>The focus on gender inequality as a basis for family and sexual violence downplays aspects of LGBTIQ people’s experiences that are directly related to their <a href="http://static1.squarespace.com/static/54d05b39e4b018314b86ca61/t/55ac6c37e4b0f1200fcd24e1/1437363255085/Tales_From_Another_Closet.pdf">sexuality or gender identity</a>. </p>
<p>Heterosexism, homophobia and transphobia often play a role in shaping the experiences of LGBTIQ people. If a person isn’t “out” about their identity, for instance, their perpetrator may use this as a threat against them to control their behaviour. Or they may claim such behaviour is “normal” in an “equal” same-sex relationship and that police will not take their complaints seriously. </p>
<p>Partners of transgender people can stop them from taking their hormone medication, or expressing their gender identity. Same-sex-attracted and gender-diverse people can also be targeted for <a href="http://www.aic.gov.au/publications/previous%20series/vpt/1-2/vpt2.html">sexual violence</a> because of <a href="http://www.glhv.org.au/files/PrivateLives2Report.pdf">their identity</a>. </p>
<h2>Barriers to getting help</h2>
<p>Poor recognition of LGBTIQ family and sexual violence means people face barriers to accessing the justice system and <a href="http://www.glhv.org.au/files/ComingForwardReport.pdf">support services</a> such as the police or emergency accommodation. These services are often geared solely towards the needs of heterosexual women.</p>
<p>Focusing solely on men’s violence against women can act as a further barrier to LGBTIQ people <a href="http://link.springer.com/article/10.1007/s10612-013-9221-4">recognising</a> and labelling their experiences of family or sexual violence, and to <a href="http://static1.squarespace.com/static/54d05b39e4b018314b86ca61/t/55ac6babe4b075430cc38db9/1437363115609/Gap_Analysis.pdf">seeking help</a> or reporting to the justice system. </p>
<p>Similar issues arise when other intersectional factors, such as <a href="http://anrows.org.au/publications/landscapes/innovative-models-in-addressing-violence-against-indigenous-women-state">race or cultural background</a>, class or disability are taken into account. </p>
<p>People living with disabilities, for example, are <a href="http://www3.aifs.gov.au/acssa/pubs/issue/acssa_issues9.pdf">disproportionately and overwhelmingly</a> likely to experience sexual violence regardless of gender, though women with disabilities are more likely again to be <a href="http://www.pwd.org.au/documents/temp/FS_Violence_WWD%27s.pdf">victims</a>. While gender is clearly relevant here, the social construction of disability and the ways in which this may contribute to sexual victimisation also require our attention. </p>
<p>We need to take into account a complex array of structural, social and cultural factors, and the ways in which they intersect with one another in different contexts. </p>
<h2>Rethinking the centrality of gender</h2>
<p>This is not to say that gender is unimportant when trying to make sense of sexual and family violence. Violence plays out in highly gendered ways. </p>
<p>Most incidents of sexual violence, for example, are <a href="http://anrows.org.au/publications/fast-facts/violence-against-women-key-statistics">perpetrated by men against women</a>. Likewise, men who enact certain types of masculinity – such as <a href="http://www.sscnet.ucla.edu/comm/malamuth/pdf/96JOR23.pdf">hostile masculinity</a> – are more likely to be the perpetrators of such violence. </p>
<p>Gendered norms are also likely to play a role in the experiences of LGBTIQ people, people living with a disability, and so on. The point here is not that gender has no explanatory power. Clearly, it is very significant. To paraphrase Julia Gillard, gender does not explain everything about family violence, nor does it explain nothing. </p>
<p>But gender is insufficient to fully account for the experiences of diverse groups. A complex and intersecting set of structural, social and cultural factors are also at play. </p>
<p>In order to fully understand, address and, ultimately, prevent sexual and family violence, we need to recognise and better understand these factors. They need to become central to our understandings of, and responses to, this violence, rather than remaining at the margins. </p>
<p><em>Bianca will be online for a Twitter Q&amp;A between 3 and 4pm AEDT on Thursday, November 12, 2015. Head over to Twitter and join in using #AskAnExpert.</em></p>
<p><em>For sexual and family violence support, visit <a href="http://www.anothercloset.com.au/">Another Closet</a> or call <a href="https://www.1800respect.org.au/">1800 RESPECT</a>.</em></p><img src="https://counter.theconversation.com/content/50238/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bianca Fileborn receives funding from La Trobe University to undertake research on sexual violence. </span></em></p><p class="fine-print"><em><span>Philomena Horsley does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people experience family and sexual violence at rates similar to, or higher than, heterosexual women.Bianca Fileborn, Research Officer at the Australian Research Centre for Sex, Health & Society, La Trobe UniversityPhilomena Horsley, Senior Trainer & Research Fellow, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/490492015-11-03T00:31:02Z2015-11-03T00:31:02ZCountry women are more likely to experience intimate partner violence<figure><img src="https://images.theconversation.com/files/99288/original/image-20151022-8019-sv4it2.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Emotional abuse was the most common form of abuse</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-154342955/stock-photo-one-sad-woman-sitting-on-the-floor-near-a-wall-and-holding-her-head-in-her-hands.html?src=8qWUxxPd7Q2I_28h73HQBQ-8-106">altanaka/Shutterstock</a></span></figcaption></figure><p>Women in regional and rural areas of Australia experience higher rates of violence from partners and spouses than women living in major metropolitan centres, my <a href="http://www.tandfonline.com/doi/abs/10.1080/18374905.2015.1039752">new research</a> has found.</p>
<p>Colleagues and I examined data from 7,917* women participating in the <a href="http://www.alswh.org.au/">Australian Longitudinal study of Women’s Health (ALSWH)</a>. </p>
<p>While one in five (20%) women living in major metropolitan centres <a href="http://www.tandfonline.com/doi/abs/10.1080/18374905.2015.1039752">reported having</a> been in a violent relationship with a partner or spouse at some time in their adult life, these numbers rose to one in four women from regional (24%) and rural (26%) areas. </p>
<h2>Increased vulnerability</h2>
<p>Past research has shown that living in rural and remote areas increases women’s <a href="http://www.nrwc.com.au/Portals/43/Documents/WAV%20Tool%20Kit/NRWN-Family-Violence-Toolkit-Factsheet4.pdf">vulnerability</a> to partner violence.</p>
<p>Compared to metropolitan areas, people living in Australian regional and rural communities have higher rates of <a href="http://www.ncbi.nlm.nih.gov/pubmed/20579021">alcohol misuse</a> and increased access to <a href="http://www.legal-info-legale.nb.ca/en/uploads/file/pdfs/Family_Violence_Firearms_Animal_Abuse.pdf">firearms</a>, both of which have been shown to increase the risks of partner violence in international studies.</p>
<p>Living in rural and regional areas also restricts women’s ability to <a href="http://www.deakin.edu.au/__data/assets/pdf_file/0003/287040/Landscapes-of-Violence-online-pdf-version.pdf">leave violent relationships</a>. Country women are more likely to be isolated and have to travel greater distances to get support from family and friends, and to access formal police and domestic violence support services. </p>
<p>Access to medical assistance, health services and counselling services are all reduced in rural areas compared to major cities. </p>
<p>Offenders or victims may be widely known in rural or regional communities. This can act as a barrier to reporting partner violence and seeking help. This is especially true if the perpetrator of the violence holds a respected position, or if victims have many roles within the community. </p>
<h2>Type of abuse</h2>
<p>Our study also <a href="http://www.ruralhealth.org.au/13nrhc/images/paper_Dillon%2C%20Gina.pdf">compared the type of partner abuse</a> women living in metropolitan, regional and rural areas faced over a twelve month period. Using detailed answers, we noted the proportion of women experiencing physical, emotional, sexual abuse or harassment behaviours.</p>
<p>Overall women from metropolitan, regional and rural areas reported the four types of abuse at very similar rates. In the past 12 months:</p>
<ul>
<li>12.5% of respondents reported emotional abuse </li>
<li>2.5% reported physical abuse</li>
<li>2.8% reported harassment </li>
<li>0.6% reported sexual abuse.</li>
</ul>
<p>Some women reported multiple types of abuse simultaneously. </p>
<p>Experiencing partner abuse has serious negative physical and mental <a href="http://www.hindawi.com/journals/ijfm/2013/313909/">health effects</a>. These health conditions can remain even after the abuse has stopped, through ongoing problems with depression, anxiety and post-traumatic stress disorder. </p>
<h2>Access to support</h2>
<p>The reduced availability of support services in non-metropolitan areas means women may have to leave their community and travel to another town to find safety or to access the help they need. This can increase the distress already present from an abusive relationship. </p>
<p>It can have other serious effects such as loss of employment, reduced contact with family and friends, lower probability of accessing medical services, and disruption to the schooling and emotional stability of children. </p>
<p>One specific area of concern in regional and rural areas is the lack of crisis and longer-term affordable accommodation for victims of intimate partner violence who are forced to leave their homes to escape from a violent partner. Lack of suitable, affordable accommodation for women, especially those with children, is one of the main barriers to women <a href="http://www.ahuri.edu.au/downloads/publications/EvRevReports/AHURI_Positioning_Paper_No140_Homelessness_prevention_for_women_and_children_who_have_experienced_domestic_and_family_violence_innovations.pdf">leaving</a> abusive partners and can also be a main reason for women <a href="http://www.uws.edu.au/__data/assets/pdf_file/0011/69590/Microsoft_Word_-_Finalreport.pdf">returning</a> to an abusive partner.</p>
<p>So not only are women in regional and rural areas more likely to experience partner violence than their city counterparts, it’s more difficult to remove themselves from violent relationships and re-establish a life for themselves and their families. </p>
<h2>Targeted response</h2>
<p>The <a href="http://www.community.nsw.gov.au/parents,-carers-and-families/domestic-and-family-violence/staying-home-leaving-violence">Staying Home Leaving Violence</a> scheme is one current program in New South Wales that helps victims of intimate partner violence remain safely in their home while the perpetrator is removed. This means less emotional upheaval for the victims and their children.</p>
<p>The program involves police, legal and community services in firstly removing the perpetrator of the abuse and then assessing the risk of further violence from this person. It also provides practical and emotional support to victims including security devices in the family home and information on safe responses to violence and abuse. </p>
<p>It’s encouraging to see this scheme is being expanded to four more regional and rural areas with funding from the recent <a href="https://www.nsw.gov.au/news/reducing-domestic-violence-0">NSW state government initiative</a> against domestic violence. It should be expanded to more sites across Australia.</p>
<p>As the Australian government begins to allocate <a href="http://www.smh.com.au/federal-politics/political-news/malcolm-turnbulls-scathing-attack-on-men-who-commit-domestic-violence-20150923-gjtpqt.html">A$100 million of funding</a> to the issue of partner violence, policymakers must ensure adequate funding for domestic violence services in rural and regional areas. This is especially important in the areas of accommodation, counselling and support services.</p>
<hr>
<p><em>The National Sexual Assault, Family &amp; Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.</em></p>
<p><em>* This figure has been amended from 14,000 to 7,919.</em></p><img src="https://counter.theconversation.com/content/49049/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This research was funded through the Collaborative Research Network for Mental Health and Wellbeing in Rural and Regional Communities at the University of New England.</span></em></p>Not only are women in regional and rural areas more likely to experience partner violence than their city counterparts, it's more difficult to leave and re-establish a new life.Gina Dillon, Researcher, University of New EnglandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/455922015-08-11T20:34:35Z2015-08-11T20:34:35ZActing on family violence: how the health system can step up<figure><img src="https://images.theconversation.com/files/91261/original/image-20150810-11097-txayp8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">It&#39;s estimated general practitioners see up to five abused women every week.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/ajay13/8788680283/in/photolist-eoChsp-j4Z16k-L7GYi-9s3iZm-atPGkx-91EVdy-ppoGu2-vP8SaY-cxm8dJ-n9Ex3z-7UHyig-kVkx24-9szkWh-6tkNag-7Q2htb-Bdzqn-r7c2Xo-cip6fS-ajqBBq-a1vpRx-5TxxkF-gyZCy1-b6ixja-uU64KP-nsJmh2-vWqf47-kx9i3B-6UMsE7-">Aikawa Ke/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>The health system has a vital role in ensuring doctors and nurses provide an appropriate, first-line response to victims of family violence. But it’s lagging behind. Today, I’ll be telling the <a href="http://www.rcfv.com.au/Public-Hearings">Victorian Government’s Royal Commission into Family Violence</a> how the health system can step up to the challenge.</p>
<p>At least <a href="http://www.rcfv.com.au/getattachment/6442E593-04E1-4C3D-839E-AEFFD15D00CC/Melbourne-Research-Alliance-to-End-Violence-Against-Women-and-Their-Children">80% of women</a> experiencing abuse seek help from health services, usually general practice. It’s <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1467-842X.2002.tb00344.x/abstract">estimated</a> a general practitioner sees up to five abused women weekly who <a href="http://apps.who.int/iris/bitstream/10665/85241/1/WHO_RHR_HRP_13.06_eng.pdf?ua=1">present with symptoms</a> of violence in the home. Some patients suffer depression, anxiety and long-term headaches. For others, the stress of abuse can lead to premature labour or even miscarriage. Doctors treat the symptoms and often don’t ask about the cause; women sometimes don’t tell.</p>
<p>There are currently <a href="http://www.racgp.org.au/your-practice/guidelines/whitebook/">excellent guidelines</a> some health professionals follow, but others don’t. This isn’t enough. Health professionals need compulsory training to ensure better health and safety outcomes for women and children experiencing domestic violence. Only an organisational shift can make this happen. Practitioners need a supportive environment and changes in health system protocols and polices. </p>
<p>It should be noted that many of the studies in this area are based on women, as they are the <a href="https://theconversation.com/to-change-attitudes-to-family-violence-we-need-a-shift-in-gender-views-44718">main victims</a> of severe physical and sexual abuse. But the same principles apply to male victims.</p>
<h2>Removing barriers</h2>
<p>Women face many <a href="http://www.ncbi.nlm.nih.gov/pubmed/21160053">barriers</a> to discussing family violence with professionals. They include shame, worries about being judged or disbelieved, and confidentiality concerns. Many doctors have had <a href="http://metatoc.com/papers/46353-are-future-doctors-taught-to-respond-to-intimate-partner-violence-a-study-of-australian-medical-schools">minimal to no training</a> in dealing with the effects of partner violence. Some don’t have the time to respond adequately if a patient discloses their experience.</p>
<p>Policymakers and researchers have suggested <a href="http://www.cochrane.org/CD007007/BEHAV_screening-women-intimate-partner-violence-healthcare-settings">screening</a> (asking all women attending a clinic or hospital a standard set of questions) to overcome these barriers and help doctors and nurses identify patients experiencing family violence. </p>
<p>Screening may sound like a good idea but many practitioners are <a href="https://theconversation.com/midwives-can-help-detect-domestic-violence-heres-how-37918">reluctant</a> to use it. They might feel overwhelmed by the emotional task of responding to disclosures. Further, health professionals sometimes have their <a href="http://www.stfm.org/FamilyMedicine/Vol44Issue6/Candib416">own experience</a> of family violence which, if recent, might hinder their willingness to bring it up with patients.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/91281/original/image-20150810-11097-1vxg8qq.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip">
<figcaption>
<span class="caption">Women face many barriers to discussing family violence with professionals.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
</figcaption>
</figure>
<p>Although screening helps identify some women experiencing domestic violence, the numbers are still lower than expected. Screening also doesn’t increase referrals to specialist services or improve women’s health outcomes. A US <a href="http://jama.jamanetwork.com/article.aspx?articleid=2422536&amp;linkId=15934037">study</a> released last week showed no long-term health benefits to women who were screened and provided with a partner violence resource list. </p>
<p>The <a href="http://www.who.int/reproductivehealth/publications/violence/9789241548595/en/">World Health Organisation</a> doesn’t recommend screening in health settings unless the woman is pregnant. A <a href="http://www.cochrane.org/CD007007/BEHAV_screening-women-intimate-partner-violence-healthcare-settings">global review</a> of more than a dozen studies has backed up this advice. It concludes the small amount of existing evidence shows identification increases but has little benefit to women. </p>
<h2>Training professionals</h2>
<p>The lack of evidence for screening doesn’t mean doctors and nurses shouldn’t use <a href="http://www.addictioneducation.co.uk/BMJ%20article%202008.pdf">prompting questions</a> to investigate whether family violence is present when women and children show recognised symptoms. If patients <a href="http://www.pec-journal.com/article/S0738-3991(13)00311-X/pdf">feel ready</a> to disclose abuse, health professionals should show <a href="http://www.who.int/reproductivehealth/publications/violence/9789241548595/en">empathy</a> and follow up with <a href="http://www.dhs.vic.gov.au/about-the-department/documents-and-resources/policies,-guidelines-and-legislation/family-violence-risk-assessment-risk-management-framework-manual">safety questions</a>. Women <a href="http://apps.who.int/iris/bitstream/10665/136101/1/WHO_RHR_14.26_eng.pdf?ua=1">should be</a> listened to, believed, asked about their needs, have their risk and safety assessed and be offered ongoing support.</p>
<p>Some women are ready for referrals at the point of disclosure. For the many who aren’t, studies have suggested family doctors be trained to provide supportive counselling. This <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60052-5/fulltext">has been shown</a> to reduce depressive symptoms in women experiencing abuse. </p>
<p>Advocacy is also beneficial. This is where appropriately trained <a href="http://www.researchgate.net/publication/7658230_A_randomized_controlled_trial_of_empowerment_training_for_Chinese_abused_women_in_Hong_Kong">health-care providers</a> or specialist family violence services give women information and psychological support to access community resources. Survivors can be linked with legal, police, housing and financial services. Advocacy and support intervention <a href="http://www.cochrane.org/CD005043/BEHAV_advocacy-interventions-to-help-women-who-experience-intimate-partner-abuse">trials</a> for women who have sought help from shelters report reductions in violence and improvements in mental health. </p>
<p>For training to be effective, it must be provided as part of university courses and throughout a practitioner’s career. Health professionals usually respond best when they are trained by a peer. Effective training also involves role-playing asking and responding with actors, reflections on personal attitudes towards violence against women, hearing survivor stories and reviewing patients’ files.</p>
<p>While doctors’ and nurses’ ability to respond appropriately when they suspect family violence is vital, it can only work if the broader <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61837-7/fulltext">health system</a> is supportive of women-centred care.</p>
<h2>Health system response</h2>
<p>A whole-of-system response involves an appropriate, sensitive environment for <a href="http://www.asca.org.au/Home.aspx">traumatised people</a>, <a href="https://www.thewomens.org.au/news/dr-sue-matthews-opinion-in-the-age/">strong management support</a> for the importance of the work, and practitioner support and mentoring. In the <a href="https://xnet.kp.org/domesticviolence/about/index.html">United States</a>, some of these system changes have led to a dramatic increase in numbers identified. </p>
<p>Governments should create policies to facilitate referral pathways for health professionals, both internally and externally, with community services. Policies should also ensure data collection and information-sharing between agencies. Health settings can create supportive environments with leaflets and posters promoting awareness about family violence consultations and referrals.</p>
<p>The Commonwealth government could add Medicare item numbers for general practitioners, psychiatrists, psychologists and social workers (with family violence training) – similar to the current <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-ba-fact-pat">mental health care plans</a> – to undertake safety planning. These would allow for longer, half-an-hour sessions.</p>
<p>State governments can:</p>
<ul>
<li>Allocate funding for regional health services to have family violence coordinators and for every hospital to have a clinical professional implement organisational change.</li>
<li>Allocate finances to overstretched family violence services for women, children and men.</li>
<li> Fund trauma-informed counselling for <a href="http://www.berrystreet.org.au/Assets/1252/1/Turtleprogrambrochure.pdf">mothers and children</a>, as <a href="http://www.who.int/reproductivehealth/publications/violence/9789241548595/en">recommended</a> by the World Health Organization. This would help fill Australia’s chasm of referral options, particularly for women and children who have left the relationship.</li>
</ul>
<p>Finally, we must ensure the health recommendations heard at the Royal Commission today lead to practical outcomes. If health professionals continue to only treat symptoms of family violence, the cycle of women’s physical and mental deterioration and damage to children will continue.</p><img src="https://counter.theconversation.com/content/45592/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kelsey Hegarty received funding from NHMRC for the weave trial. She has been a Temporary Clinical Advisor for the WHO and an author on the Cochrane Clinical Reviews.</span></em></p>Victoria's Royal Commission into Family Violence will today hear how the health system can better respond to partner abuse, with the help of trained professionals and broader, government support.Kelsey Hegarty, Professor, Department of General Practice; Director of Researching Abuse and Violence in Primary Care program; Director of Post graduate Primary Care Nursing, University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/376572015-03-03T19:16:54Z2015-03-03T19:16:54ZTechnology doesn't judge: using the web to address domestic violence<figure><img src="https://images.theconversation.com/files/73546/original/image-20150303-15953-1ax7zs1.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Smartphones allow users to access help, information, or support anonymously and privately. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/dakiny/14963796021">Toshihiro Gamo/Shutterstock</a></span></figcaption></figure><p>For every woman who speaks out about her experiences or reports the abuse, many more <a href="http://www.ncbi.nlm.nih.gov/pubmed/11688623">remain silent</a> through fear, <a href="http://www.ncbi.nlm.nih.gov/pubmed/15209200">shame</a>, or simply because they don’t know who to turn to. Many don’t even tell their closest friends, family members, or general practitioner, let alone pick up the phone to call a domestic violence hotline or counselling service.</p>
<p>This reluctance to seek help is alarming when we consider the grim statistics on domestic violence. <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4906.0Chapter3002012">One in five women</a> in Australia have experienced physical or sexual abuse at the hands of an intimate partner. <a href="http://www.aic.gov.au/media_library/publications/mr/21/mr21.pdf">One woman is killed</a> each week by her current or ex-husband, partner, or boyfriend. <a href="https://www.facebook.com/notes/destroy-the-joint/counting-dead-women-australia-2015/839061602808252">Seventeen women</a> have already died this year, and it’s only March.</p>
<p>Thanks to activists such as Rosie Batty, there has been a <a href="http://www.dailylife.com.au/news-and-views/dl-opinion/will-rosie-battys-victory-make-australia-finally-take-domestic-violence-seriously-20150126-12y80u.html">renewed focus</a> on challenging gender stereotypes and men’s attitudes towards women in an attempt to prevent violence from occurring. While this is certainly a vital piece of the puzzle, the patriarchy is unlikely to be dismantled overnight. </p>
<p>The proposed <a href="https://4a5b508b5f92124e39ff-ccd8d0b92a93a9c1ab1bc91ad6c9bfdb.ssl.cf4.rackcdn.com/2015/01/150119-Proposed-Terms-of-Reference2.pdf">terms of reference</a> for the Victorian government’s Royal Commission into Family Violence argue that domestic violence requires a coordinated response across government, services, and the community. But this will be difficult and time-consuming to achieve, particularly in light of the Abbott government’s <a href="http://www.sbs.com.au/news/article/2014/10/23/budget-cuts-hurting-domestic-violence-victims-senator-says">cuts</a> to critical domestic violence services. </p>
<p>Clearly, we need to think more innovatively about how we respond to this hidden epidemic. Technology – specifically, the internet and smartphone apps – may provide part of the solution. </p>
<h2>Existing technology</h2>
<p>The internet and smartphone apps are readily available to large numbers of people. They allow users to access help, information, or support anonymously and privately.<br>
In the context of domestic violence, women who may not yet be ready to name their experiences as “domestic violence” can use the web or smartphone apps to assess their relationships and figure out the next steps. Most importantly, women can access help without the need to disclose the abuse to anybody, which may reduce concerns about judgement and stigma.</p>
<p>Globally, many countries are beginning to explore the possibilities for web- and smartphone-based applications to respond to domestic violence. In the <a href="http://www.pdx.edu/sites/www.pdx.edu.wrc/files/Iris_Study_Summary.pdf">United States</a>, <a href="http://playunite.org/Moraba_Gender_Game.pdf">South Africa</a>, and <a href="https://nzfvc.org.nz/news/online-study-improve-safety-and-mental-health-women-experiencing-abuse">New Zealand</a>, for example, interactive tools are being developed and evaluated to help women make decisions and learn about respectful relationships.</p>
<p>In Australia, we are also starting to recognise the potential of technology, with several domestic violence apps such as <a href="http://www.women.nsw.gov.au/violence_prevention/domestic_and_family_violence_app">Aurora</a> and <a href="https://play.google.com/store/apps/details?id=au.org.doncare.imatter&amp;hl=en">iMatter</a> already helping women connect to formal services and access practical information. iMatter, which is targeted at younger women, also promotes self-respect and empowerment.</p>
<h2>Towards tailored support</h2>
<p>Technology has the potential to do more than inform and link to services; it can help provide the individualised, tailored support women need when experiencing abuse at the hands of an intimate partner. </p>
<p>Our research team is developing a web tool called <a href="http://www.idecide.org.au">I-DECIDE</a>, which allows women to reflect on an unhealthy or unsafe relationship and manage their situation. </p>
<p>I-DECIDE uses validated tools to identify the type of abuse (emotional, physical, or combined) a woman may be experiencing, as well as her level of danger and risk, and provides feedback. It also incorporates reflective exercises around relationship health and safety. </p>
<p>Drawing on a face to-face <a href="http://www.ncbi.nlm.nih.gov/pubmed/23598181">counselling program</a> for general practitioners, I-DECIDE uses motivational interviewing and non-directive problem-solving techniques. These help women determine their own needs and the steps they might take to improve their safety and well-being, acknowledging that the step chosen may not always be leaving the relationship. </p>
<p>I-DECIDE responds to women’s individual priorities by providing strategies and resources that are unique to her situation, rather than general standardised links to information and resources. Perhaps most importantly, the program culminates in an individualised “action plan”. </p>
<p>Preliminary testing has been positive. One woman commented that after using I-DECIDE:</p>
<blockquote>
<p>I feel affirmed and deserving. I feel it helped me recognise what I had been prioritising over my own health and well-being, and reminded me to keep perspective about my partner’s behaviour.</p>
</blockquote>
<h2>Potential barriers</h2>
<p>There are, however, some challenges that need to be addressed when harnessing technology to respond to domestic violence. </p>
<p>The <a href="http://www.dvrcv.org.au/knowledge-centre/technology-safety">rise of online abuse</a> and cyber-stalking by partners or ex-partners is a major concern. Appropriate security measures need to be put in place to ensure women’s safety when using websites or apps. </p>
<p>Additionally, it’s difficult to address the whole spectrum of relationship issues with one website or app. Telephone and face-to-face contact will still play an important role in responding to women’s needs.</p>
<p>Any response approach has the risk of alienating women through use of inappropriate language. Many women will not identify with “domestic violence”, “family violence” or “violence against women” language or services. We have carefully called this website “I-DECIDE About My Relationship” in an attempt to reach out to women who may not have named their relationships as abusive. </p>
<p>I-DECIDE is currently being evaluated through a randomised controlled trial, which will determine its effectiveness in addressing domestic violence in the wider population. Women eligible for the trial can access I-DECIDE immediately. It will be made available to all women in 2016.</p>
<hr>
<p><em>If you or someone you know would like to participate in the I-DECIDE project, visit <a href="http://www.idecide.org.au">the website</a>.</em></p>
<p><em>Anyone at risk of family and domestic violence and/or sexual assault can seek help 24 hours a day, seven days a week, either <a href="https://www.1800respect.org.au/">online</a> or by calling 1800 RESPECT (1800 737 732). Information is also available in <a href="https://www.1800respect.org.au/languages/">28 languages other than English</a>.</em></p>
<p><em>Read other articles in The Conversation’s ongoing <a href="https://theconversation.com/au/topics/domestic-violence">domestic violence</a> coverage.</em></p><img src="https://counter.theconversation.com/content/37657/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Tarzia is the coordinator of the I-DECIDE project at The University of Melbourne. She receives funding from the Australian Research Council.</span></em></p><p class="fine-print"><em><span>Kelsey Hegarty is the Chief Investigator on the Australian Research Council funded project I-DECIDE</span></em></p>For every woman who reports domestic abuse, many more remain silent through fear, shame or simply because they don’t know who to turn to. But new digital programs could help.Laura Tarzia, Research Fellow, Deputy Lead Abuse & Violence Program, Department of General Practice, University of MelbourneKelsey Hegarty, Professor, General Practice and Primary Health Care Academic Centre; Director of Researching Abuse and Violence in Primary Care program; Director of Post graduate Primary Care Nursing, University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/376962015-02-23T19:31:40Z2015-02-23T19:31:40ZAlcohol's link to domestic violence is in focus – now what?<figure><img src="https://images.theconversation.com/files/72724/original/image-20150223-21907-yi6owh.jpg?ixlib=rb-1.1.0&amp;rect=0%2C208%2C2628%2C1683&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Limited attention has been given to efforts aiming to reduce alcohol-related intimate partner violence by reducing harmful drinking.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/jenny-pics/2904201123">jenny downing/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>By mapping alcohol’s role in domestic violence, a <a href="http://www.fare.org.au/research-development/featured-research/alcohols-harm-to-others/">report published today</a> lifts the lid on the plight of numerous Australian adults and children whose lives are negatively affected by a family member with alcohol problems. </p>
<p>Much attention has been paid to alcohol-related violence in and around pubs and clubs, and on the streets. Highly visible, this violence often has tragic consequences and attracts deserved condemnation from the public, as well as being legal sanctioned in some jurisdictions. </p>
<p>But the significant proportion of alcohol-related assaults taking place daily in family homes goes largely unseen. Drawing on two national surveys, service system data and qualitative interviews with families, The hidden harm: Alcohol’s impact on children and families, a report by the <a href="http://www.capr.edu.au/">Centre for Alcohol Policy Research</a>, details alcohol’s damage in the home. </p>
<h2>Alcohol-related domestic violence</h2>
<p>Alcohol is <a href="http://www.fare.org.au/wp-content/uploads/2011/10/The-Range-and-Magnitude-of-Alcohols-Harm-to-Others.pdf">estimated</a> to be involved in up to half of partner violence in Australia and 73% of partner physical assaults. It features prominently in police data, although not all jurisdictions keep consistent records.</p>
<p>In 2010, alcohol was recorded as “present” in <a href="http://www.bocsar.nsw.gov.au/agdbasev7wr/bocsar/documents/pdf/bb61.pdf">41% of domestic assaults in New South Wales</a>. This figure increased to over 60% in the remote far west of the state. </p>
<p><a href="http://aodstats.org.au">Victorian data</a> shows a steady rise in the rate of alcohol-related family violence incidents from about 15 to 23 incidents per 10,000 people over a ten-year period. </p>
<p>Given incidents reported to police are often the most severe cases, and only one-third of domestic violence is reported anyway, the figures discussed above clearly under-represent the full extent of alcohol-related domestic violence.</p>
<h2>Making things worse</h2>
<p>Much debate about alcohol’s role in domestic violence focuses on the question of whether alcohol actually causes the violence. After all, men who don’t drink alcohol are also perpetrators of such violence and most people who drink are not violent. </p>
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<img alt="" src="https://images.theconversation.com/files/72725/original/image-20150223-21879-l99rix.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip">
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<span class="caption">Women’s problem drinking alone doesn’t make violence more likely.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/photodpm/8231455078">Juanjo Gutiérrez/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
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<p>Domestic violence is complex behaviour with multiple factors and influences. What we know is that the <a href="http://www.biomedcentral.com/1471-2458/11/109">risk of violence increases</a> when alcohol is involved, and that the <a href="http://jiv.sagepub.com/content/26/8/1503">victim’s injuries are more severe</a> in those instances. Children are affected by witnessing domestic violence and alcohol also increases the <a href="https://www3.aifs.gov.au/cfca/publications/improving-outcomes-children-living-families-pare">risk of children</a> being abused, neglected and emotionally damaged. </p>
<p>Alcohol also features strongly in domestic violence murders. According to the Australian Institute of Criminology almost half (44%) of all <a href="http://www.aic.gov.au/documents/6/F/F/%7B6FF03CB5-1EF7-43EE-84FC-F0997C5C84C9%7Dtandi372_001.pdf">intimate partner homicides</a> between 2000 and 2006 were alcohol-related, involving consumption by the victim, offender, or both. </p>
<p>This rate is even higher for Indigenous Australians. <a href="http://www.aic.gov.au/documents/6/F/F/%7B6FF03CB5-1EF7-43EE-84FC-F0997C5C84C9%7Dtandi372_001.pdf">Intimate partner deaths involving an Indigenous offender and victim</a> are 13 times as likely to be related to alcohol.</p>
<h2>Who’s most affected?</h2>
<p>Women are disproportionately the victims of domestic violence and this also holds true for incidents involving alcohol. </p>
<p>A 2010 <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421314">national survey</a> of alcohol consumption and harm in Australia found women are more likely to experience alcohol-related abuse from a spouse or partner, whereas men are more likely to report it from a stranger. </p>
<p>Over 21% of women reported being fearful of their partner’s drinking compared with 6.3% of men. And almost 40% of women reported experiencing alcohol-related physical abuse within an intimate relationship compared with 11% of men.</p>
<p><a href="http://vaw.sagepub.com/content/21/1/65.short">Women are more likely to report</a> violent incidents to police where their male partner is drunk, highlighting the seriousness of assaults involving alcohol. </p>
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<img alt="" src="https://images.theconversation.com/files/72726/original/image-20150223-21904-1ey4zla.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip">
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<span class="caption">Heavy and binge drinking increases the likelihood of violence occurring in intimate relationships.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/timquijano/5335404178">timquijano/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p><a href="http://www.biomedcentral.com/1471-2458/11/109">Studies across multiple countries</a> show that the risk of violence is higher when the male partner drinks or when both partners drink. Women’s problem drinking alone doesn’t make violence more likely. </p>
<h2>It’s the way we drink</h2>
<p>It’s not the amount of alcohol consumed that’s important but the pattern of drinking; heavy and binge drinking increases the likelihood of violence. </p>
<p><a href="http://www.aic.gov.au/documents/5/8/D/%7B58D8592E-CEF7-4005-AB11-B7A8B4842399%7DRPP56.pdf">Australian research</a> on women’s experience of male violence showed married women whose husbands got drunk a couple of times a month were three times more likely to experience physical violence. High rates of violence are also commonly found among couples where one partner is seeking <a href="http://psycnet.apa.org/journals/ccp/63/2/256/">treatment for alcohol dependence</a>. </p>
<p>This pattern also holds among younger people. <a href="http://epirev.oxfordjournals.org/content/early/2011/11/29/epirev.mxr027.short">Youth dating violence perpetration</a> has strong links to higher levels of alcohol consumption. Interventions that target binge drinking in young adults may present opportunities for early intervention to prevent and reduce alcohol-related intimate partner violence in later life.</p>
<p>Focusing prevention efforts on alcohol is not a way of excusing or diminishing men’s responsibility for their drinking or violence. Rather, it offers a possible lever for change in an intractable problem. </p>
<p>To date, <a href="http://www.biomedcentral.com/1471-2458/14/881">limited attention</a> has been given to efforts for preventing alcohol-related intimate partner violence by reducing harmful drinking. This new report presents a timely reminder of the women and children whose lives are marred by another person’s problem drinking. It should provide the impetus to act on this widespread and insidious problem.</p><img src="https://counter.theconversation.com/content/37696/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ingrid Wilson receives an Australian Postgraduate Award from the Australian Department of Education and Training.
Ingrid has received an airfare to attend the FARE Hidden Harm launch and provide expert advice to the associated policy roundtable.</span></em></p><p class="fine-print"><em><span>Angela Taft has received an airfare to present research at the FARE Hidden Harm launch.</span></em></p>By mapping alcohol’s role in domestic violence, a report published today lifts the lid on the plight of numerous Australian adults and children whose lives are negatively affected by a family member with…Ingrid Wilson, PhD student, La Trobe UniversityAngela Taft, Professor and Director, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.